Mirizzi Syndrome & Acalculous Cholecystitis Flashcards
Mirizzi Syndrome pathop with one important sign
In this rare complication, a gallstone lodges in the cystic duct of the gallbladder, and the resulting compression of the common bile duct (CBD) or common hepatic duct causes obstruction and jaundice
Mirizzi Syndrome levels of bilirubin and alkaline phosphatase.
high
Mirizzi Syndrome best initial test
US
Mirizzi Syndrome most accurate test
mrcp
Mirizzi Syndrome mainstay of therapy.
For simple cases, surgical resection of the gallbladder
Mirizzi Syndrome If a fistula
has developed, management
cholecystectomy and bilioenteric anastomosis may be required
Acalculous Cholecystitis patho
is an inflammatory disease of the gallbladder caused by bile stasis, ischemia, and bile salt concentration; there is no evidence of
gallstones or cystic duct obstruction.
Critically ill patients are more susceptible to have Acalculous Cholecystitis
because _________________
cholecystokinin-induced gallbladder contraction is suspended in patients who do not eat.
Acalculous Cholecystitis is most commonly seen in [epidemiology]
patients with sepsis or receiving TPN.
Acalculous Cholecystitis most common complication
secondary infection with enteric pathogens is
common (e.g., Escherichia coli, Enterococcus faecalis, Klebsiella, Pseudomonas, Proteus, and Bacteroides fragilis
Acalculous Cholecystitis Diagnosis
Diagnosis is made through a combination of clinical presentation and history.
While imaging is not specific enough to confirm acalculous cholecystitis, it is
used to exclude other conditions.
Acalculous Cholecystitis tx
Low-risk patients: emergency laparoscopic cholecystectomy
High-risk patients: percutaneous cholecystostomy
If patients do not improve within 2–3 days, cholecystectomy should be performed.
Acalculous Cholecystitis Surgery is reserved for patients who also have:
Gallbladder necrosis
Emphysematous cholecystitis
Gallbladder perforation
