wk 6 9 - pathology of biliary tract and pancreas Flashcards
gallstones medical name
cholelithiasis
what stimulates the release of bile from the gallbladder
CCK
where is bile secreted
ampulla of vater (meeting common bile duct) and entering duodenum at the sphincter of oddi
what causes the formation of gallstones
cholesterol stones - high cholesteron, impairs micelle formation
pigment stones - excess bilirubin, cannot be solubilised
what is micelle formation
hydrophilic head and hydrophobic tails in lipids
excess bilirubin is due to excesss
haemolysis
when is haemolysis seen
haemolytic anaemias
pigment or cholesterol stones are unlikely to be pure, or develop from the pathogenesis alone. what are some contributing factors 3
gallbladder ph
mucosal glycoproteins
infection/inflammation of biliary lining
cholecystitis
inflammation of gallbladder
likely causes of acute cholecystitis
gallstones
acute cholestylttis may lead to
empyema
rupture
peritonitis
how can boouts of acute cholecystitis lead to chronci
intense adhesions can develop over days
multiple inflammations could lead to wall thickening - total occlusion causing chronic
which carcinoma is liver to occur in gallbladder
adenocarcinoma
altho rare
2 diseases which cholangiocarcinoma is associrred with
UC
PSC
how would cholangiocarcinoma present
obstructive jaundice
densely packed small glands in a fibrous stroma
this describes
cholangiocarcinoma
a patient with elevated serum amylase, severly shocked with intense RUQ pain is likely to be
acute pancreatitis
cholelithiasis
formation of gallstones
acute pancreatitis can be due to bile reflux from duct obstruction due to a stone damaging the sphincte rof oddi, causing epithelial damage. what does this cause leading to pancreatiti
loss of protective barrier, allows autodigestion of pancreatic acini
autodigestion of pancreatic acini leads to the release of what? what does this cause
proteases and lipases
protease - tissue destruction + haemorrhage
lipase - intra/peripancreatic fat necrosis
for mild,mod,severe acute pancreatitis, outline what would be found on biopsy
mild - focal areas of necrosis in body of pancreas, superficial
mod - intrapancreatic fat necrosis
severe - complete pancreatic destruction, with haemorrhage and fat necrosis
possible complications of acute pancreatitis 6
pseudocyst formation abscess formation hypocalcemia# hyperglycemia shock death
chronic pancreatitis can develop from
alcohol abuse cholelithiasis cystic fibrosis hyperparathyroidism genetics
chronic pancreatitis is the replacement of pancreas to chronic inflammation and scar tissue, what doez this destroy?
destructioon of exocrine acini and islets (insulin secreting cell)
