011415 gallbladder Flashcards
biliary colic pain
liver, gallbladder, and bile ducts have sympathetic afferent fibers that go through splanchnic nerves and mediate this pain
risk factors for cholesterol gallstones
increasing age female pregnancy obesity rapid weight loss biliary sludge (associated with certain drugs) etc
inflam disorders of gallbladder
acute cholecystitis (gallbladder inflam)
acute cholangitis (gallstone pancreatitis)–biliary tract
acalculous cholecystitis (inflam directed to gallbladder but no evidence of stone formation)
PSC
AIDS cholangiopathy
symptoms of acute cholecystitis
R epigastric pain with fever and leukocytosis associated w gallstone obstruction of cystic duct
LIES STILL
diagnostic studies for acute cholecystitis
US (detects stones)
cholescintigraphy (HIDA scan)–labeled HIDA is injected IV to trace
Charcot’s triad
acute cholangitis
fever, jaundice, abd pain
from stasis in biliary tract
complication from acute cholangitis
increased permeability of bile ductules (due to increased pressure) permits translocation of bacteria and toxins from portal circulation or from duodenum
what can you do to tx acute cholangitis
ERCP (endoscopic retrograde cholangiopancreatography) to drain
symptoms of acalculous cholecystitis
similar to acute cholecystitis but no gallstones
PSC
inflam, fibrosis, stricturing of medium/large ducts in intrahepatic/extrahepatic biliary tree
biliary colic pain begins where
mid-epigastrium (then can go to R shoulder/interscapular area)
biliary colic could point to
cystic duct obstruction
is biliary colic pt restless or lying still?
restless
chronic RUQ pain
be suspicious. almost never caused by gallbladder disease
some pts with gallstones can be asymptomatic: true or false
true–on asymptomatic pts, just leave it alone
