vias biliares Flashcards

1
Q

DX e TTO LESAO DE VIA BILIAR

A

-CRNM (icetricia + febre pos op )

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2
Q

CALCULOS CASTANHOS e PRETOS

A

-Origem na VIA BILIAR, associado a ascaris e bacterias
-Radiodenso, associado a A.hemolitica e dx ileal

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3
Q

cx na COLELITIASE

A

-VESICULA EM PORCELANA
-ANEMIA FALCIFORME
-SINTOMATICOS
-MICROCALCULOS
-TRANSPLANTE
BYPASS GASTRICO ou GASTRECTOMIA
-CALCULO > 2,5 CM

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4
Q

TRIANGULO DE CALLOT

A

-LATERAL : DUCTO CISTICO
-MEDIAL : DHC
-SUP: BORDA INFERIOR DO FIGADO
-PASSA : A CISTICA ( A.Hepatica DIREITA )

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5
Q

PADRAO OURO DA COLECISTITES

A

CINTILOGRAFIA BILIAR

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6
Q

TTO DE COLECISTITES

A

-ATB ( CIPRO + METRO )
-HIDRATACAO + ANALGESIA
-COLECISTECTOMIA EM 72 HS

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7
Q

SUSPEITA DE EMPIEMA DE VESICULA , TTO

A

-ATB + DRENAJEM PERCUTANEA

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8
Q

AGENTE DA COLECISTITES ENFISEMATOSA

A

-Clostridium PERFRINGES
-PADRAO OURO: GAS NA TAC

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9
Q

SUSPEITA DE COLECISTITE ALITIASICA

A

-GRAVE, UTI, IDOSO, QUEIMADO
-PIOR PROGNOSTICO

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10
Q

LABORATORIO DE COLEDOCOLITIASE

A

-AUMENTO DE BD, FA, GGT

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11
Q

COLANGIOTRANSOPERATORIA

A

-NAO TIROU O CALCULO COM CPRE
-CI DE CPRE :
-LESAO DE VIA BILIAR

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12
Q

CONDUTA DA COLEDOCOLITIASE SEGUNDO O RISCO

A

-ALTO : CPRE + Colecistectomia lapa eletiva
-MEDIO: COLANGIORM , US ENDOSCOPICO e COLANGI INTRAOPERATORIA
-BAIXO: COLECISTECTOMIA

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13
Q

SEGUNDO RISCO DE COLEDOCOLITIASE

A

-ALTO: colecolitiase na USG , BD > 4, COLANGITE
-MEDIO: coledoco >6mm ou BD 1,8 a 4
-BAIXO: LAB alterado ou pancreatite

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14
Q

sx de Bouveret

A

calculo biliar impactado no PILORO

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15
Q

CA de vesicula

A

-Intraoperatrio
-Agressio + calculos >2,5
-Mulheres de >60a
-90% Adenocarcinoma

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16
Q

SX mirizzi fases

A

1:compressao do ducto comum
2: 1\3 da circun ( cole + tubo)
3: 2\3 da circun ( cole + anastomose biliodigestiva)
4: toda circun ( coledojejunostomia )
5: colecistoenterica

17
Q

vesicula atrofica suspeita de

A

Colangiocarcinoma

18
Q

indicacao de ECOENDOSCOPIA

A

Microcalculos e obesos

19
Q

Conduta em PANCREATITE de origem biliar

A

tto conservador seguido de colecistectomia laparosocipica na MESMA INTERNACAO

20
Q

exame de escolha e de etiologia pra pancreatite

A

TAC e USG abdominal

21
Q

ictericia no pos operatorio de COLECISTECTOMIA

A

-Lesao de via biliar ( bifurcacao do ducto hepatico )
-Coledocolitiase residual