RUQ pain

Question 1

what is hydrops of the gallbladder?

Answer 1

• complete obstruction of the cystic duct by a gallstone
• gallbladder is filled with mucus, not bile
• seen as white fluid

Question 2

Gilbert’s syndrome

Answer 2

inborn error in liver bili uptake / glucuronyl transferase –> hyperbili

Question 3

Courvoiser’s gallbladder

Answer 3

• palpable, non-tender gallbladder
• seen with cancer of the head of the pancreas
• distends b/c it has nto been scarred down by gallstones

Question 4

mirizzi’s syndrome

Answer 4

• common hepatic duct obstruction

- extrinsic compression from a gallstone in the cystic duct

Question 5

what is murphy’s sign?

Answer 5

when palpating RUQ, ask patient to breathe –> arrest of inspiration (gallbladder brought up to tips of fingers & inflammation causes pain)

Question 6

what is gallstone ileus?

Answer 6

SBO from gallstone >2.5 cm that has eroded through the gallbladder and into the duodenum/small bowel

Question 7

where is the classic site of obstruction in gallstone ileus?

Answer 7

ileocecal valve - cause of obstruction in the duodenum / sigmoid colon

Question 8

what are findings of gallstone ileus?

Answer 8

1) air in the hepatic bile ducts
2) SBO w/ air fluid levels
3) gallstone in ileocecal valve