What is cholelithasis?
Where are gallstones most commonly found?
1. Gallbladder (because it's static)
2. Biliary system (less common because the bile flows)
How are symptomatic gallstones removed?
What are the three main components of bile?
Where is bile stored and concentrated?
Which signal triggers the release of bile into the duodenum?
Why do gallstones occur?
Imbalance of ratio between cholesterol and bile salts
i.e too much cholesterol
cholesterol crystalises to form solid stones.
Who gets gallstones?
What is haemolytic anaemia?
Increased breakdown of red blood cells, more Hb to metabolise
⇒ increased unconjugated bilirubin which the liver can't handle
Apart from excess cholesterol, what other factor associated with haemolytic anaemia causes gallstones?
Name the two types of gallstone.
Pigment (bilrubin) stones
What do gallstones cause in the biliary lining?
chronic cholecystitis is constant waves of inflammation
mucocoele - buildup of mucus
empyema - buildup of pus
ascending cholangitis - gallstone blocks bile duct leading to ascending cholangitis (infection)
gallstone ileus - eroding action of gallstone forms fistula between duodenum and gall bladder, then travels to terminal ileum and blocks ileocaecal valve
pancreatitis - gallstone blocks sphincter of oddi, pancreatitis, autodigestion of pancreas by its own enzymes
What is cholecystitis?
What is it usually associated with?
Inflammation of the gallbladder
What causes acute cholecystitis?
Gallstones blocking outflow of bile
In acute cholecystitis, the gallbladder is initally sterile but soon becomes ___.
What are some complications of acute cholecystitis?
If gallstones remain after a bout of acute cholecystitis, what can occur?
What happens to the muscle coat of the gallbladder in chronic cholecystitis?
What type of cancer rarely occurs in the gallbladder?
Adenocarcinoma of the gallbladder is associated with ___.
Where can it directly spread?
What is cancer of the bile ducts called?
What diseases are associated with cholangiocarcinoma?
Primary sclerosing cholangitis
(which itself is associated with UC)
What are cholangiocarcinomas also called?
The pancreas is intimately associated with other organs.
Name these associations according to each part of the pancreas.
Head - duodenum, stomach, liver
Neck - bile ducts, stomach, IVC and abdominal aorta
Body - stomach, splenic artery/vein
Tail - spleen, left adrenal gland
In terms of the GI tract, the pancreas is heavily involved in ___ of food.
In terms of the endocrine system, removing the pancreas will render a patient ___.
What is pancreatitis?
Inflammation of the pancreas
What is the main symptom of acute pancreatitis?
Sudden onset severe abdominal pain
Patients with acute pancreatitis is associated with elevated serum ___.