Pathology of gall bladder and pancreas Flashcards
What is the medical term for gall stones?
Cholelithiasis
Where are gall stones most commonly formed?
Gall bladder, occasionally formed in the bile ducts
Can gall stones remain assymptomatic?
Yes and they often do
What is normal bile made from?
Micelles of cholesterol, phospholipid, bile salts and bilirubin (Cholesterol at the centre)
What causes the release of bile into the intestines?
CCK released from duodenumcauses the call bladder to contract and bile to flow into the second part of the duodenum.
What are the different types of gallstones?
1) Cholesterol gallstones
2) Pigment stones
3) Calcium carbonate stones
What is the pathogenesis of cholesterol gallstones?
Too much cholesterol in the micelles causing them to precipitate out of solution and form crystals of cholesterol
What are the risk factors for cholesterol gall stones?
Female, obesity, diabetes , genetic
What do cholestereol gall stones look like and when do they cause pain?
Cuboidal and variable in size. Normally a creamy colour. Irritate the gall bladder lining causing inflammation and thickening and cause pain after a meal when the gall bladder contracts
What causes pigment gall stones?
Too much bilirubin which cannot be solubalised in bile salts so precipitates out of solution.
What do pigment gall stones look like?
Black stones
What are the risk factors for pigment gall stones?
Excess billirubin due to haemoylictic anaemias
Which gall stones are most common?
Mixed gall stones. Cholesterol and bilirubinbut pure sones do occur
What can predispose to gall stones?
Gall bladder pH and mucosal glycoproteins => infection and inflammation of biliary lining
What are some of the consequences of gall stones?
1) Acute cholecystitis
2) Chronic cholecystitis
3) Mucocoele
4) Empyema
5) Carcinoma
6) Ascending cholangitis
7) Obstructive jaundice
8) Gall stone Ileus
9) Acute pancreatitis
10) Chronic pancreatitis
How is acute choecystitis treated?
Antibiotics
Tend not to operate in the acute phase but the gall bladder can be removed in the chronic phase
What is Mucolcele as a consequence of gallstones?
Mucus build up within the gall bladder which can lead to empyema. Treated surgically