Surgical Tut: Gallstones Flashcards
how many ppl have gall stones in their life?
20% of population
1 in 4 ppl with asymptomatic gallstones becomes symptomatic
asymptomatic gall stones, take out gall bladder? when to take out?
- leave it if asymptomatic
- if symptomatic will likely get repeat in first 3/12, and get 2 more within the year
symptoms of biliary colic
RUQ fatty meal precipitated may radiate to back anorexia nausea/vomiting sometimes
how does cholecystitis cause pain?
increase pressure in gall bladder from obstructed neck
cholecystitis? describe the symptoms
inflammation: fever
pain is more constant >12 hours
how to differentiate between biliary colic and cholecystitis?
did the pain go away at anytime?
what kind of inflammation is cholecystitis?
chemical inflammation
can still get fever
cholelithiasis complications?
infection - empyema
pancreatitis
mucoceal (builds up)
jaundice
stones in the common bile duct two complications?
cholangitis
pancreatitis
how is cholangitis fever different from other fevers eg. UTI?
rigours, fever, jaundice
ultrasound features of cholelithiasis
ultrasound positive murphy’s
thickened wall
what CT scan for biliary tree
CT IVC IV cholangiogram
when can you not use CT IVC?
if bilirubin levels are >30, as the hepatocytes can take up biliscopin
CT IVC vs. MRCP different in imaging?
- CT IVC gives you functional excretional information
- worried about bile leak
when is CT-IVC the best test for?
if suspect bile leak
