Liver and Friends

Question 1

Cholangitis definition

Answer 1

Inflammation (and secondary bacterial infection) of the bile ducts (due to biliary obstruction and stasis)

Question 2

Cholecystitis (acute or chronic) definition

Answer 2

Inflammation of the gall bladder

Question 3

Cholecyst-

Answer 3

Denoting the gall bladder

Question 4

Chol- (also Chole- or Cholo-)

Answer 4

Denoting bile

Question 5

What might the obstruction causing cholangitis be caused by?

Answer 5

Gallstones
Benign or malignant stricture
Intervention (ERCP)

Question 6

What is Sclerosing Cholangitis?

Answer 6

Inflammatory disorder characterised by progressive occlusion of intra/extrahepatic bile ducts leading to stricture formation, liver cirrhosis and liver failure. It is associated with ulcerative colitis and autoimmune disease.

Question 7

Symptoms of Cholangitis (brief)

Answer 7

Charcot’s Triad = Intermittent fever (usually + rigors), abdominal pain and intermittent jaundice

Question 8

Treatment of Cholangitis

Answer 8

Broad spectrum antibiotics and decompression of biliary tree to prevent recurrent infection

Question 9

What complicates Cholangitis?

Answer 9

Liver abscesses

Question 10

Complications of Cholangitis

Answer 10

Recurrent episodes of cholangitis can predispose to secondary biliary cirrhosis

Question 11

Causes of Acute Cholecystitis

Answer 11

It is a frequent complication of gallstones obstructing the cystic duct
In a minority of cases it can occur without gallstones (acute acalculous cholecystitis)

Question 12

Treatment of acute cholecystitis

Answer 12

Analgesia
IV fluids
Broad-spectrum antibiotics
Cholecystectomy (removal of gall bladder)

Question 13

What is chronic cholecystitis?

Answer 13

An outdated term for recurrent episodes of biliary colic

Question 14

Biliary colic definition

Answer 14

Severe abdominal pain resulting from obstruction of cystic bile duct or common bile duct.
Obstruction is commonly due to a gallstone.
Pain is in RUQ but may be poorly localised.
Often associated with meals and may last several hours.
It is constant in severity (unlike most other colic).
Vomiting often occurs.

Question 15

What did Primary Biliary Cholangitis used to be called?

Answer 15

Primary biliary cirrhosis is now called primary biliary cholangitis (as some of the patients may not actually have the cirrhosis with it)

Question 16

Brief definition of PBC (Primary Biliary Cholangitis)

Answer 16

A chronic autoimmune disorder with progressive inflammatory destruction of small bile ducts, leading to cirrhosis

Question 17

Brief definition of PSC (Primary Sclerosing Cholangitis)

Answer 17

Progressive cholestasis (failure of normal amount of bile to reach intestines) with bile duct inflammation and strictures.
Primary Sclerosing Cholangitis (PSC) is a chronic inflammatory condition that results in the fibrosis and destruction of intrahepatic and extrahepatic bile ducts. This can lead to cholestasis, hypertension and liver failure.