Gallbladder in Health and Disease Flashcards
Choledocholelithiasis vs cholelithiasis:
Choledocholelithiasis: cholesterol gallstones
Cholelithiasis: pigment gallstones
What are pigment gallstone made of?
Bilirubin and calcium salts
What are cholesterol gallstones made up of?
Cholesterol monohydrate
What hormone can affect cholesterol gallstone formation?
Estrogen because it promotes HMG-CoA that causes increased cholesterol uptake and formation
What are 4 factors that cause increased cholesterol stone formation?
- ) Over saturation of bile with cholesterol
- ) Gallbladder hypermotility
- ) Accelerated cholesterol crystal nucleation
- ) Gallbladder hypersecretion of mucus
What color and shape are cholesterol stones?
Pale to yellow the more pure are more round and less pure are multi-faceted
What color and shape are pigment stones?
Pure are black and spiculed
Brown and round smooth/greasy because an infection
Are small or large more dangerous and why?
Small because they can reach the duct and then become lodged
What is the difference between acute calculous and acute acalculous cholecystitis?
Calculous: stones
Acalculous: no stones
What typically causes acalculous cholecystitis?
Overlying severe illness or salmonella typhi; ischemia is often thought to cause
What causes calculous?
Chemical irritation and inflammation from obstruction of gall stones (not infections)
What typically causes pigment gallstones?
Parasites or bacterial infections
In calculous cholecystitis where is the stone typically blocking?
Neck of the gallbladder
Morphology of the gallbladder in acute cholecystitis?
Fibrinous serosal lining, blotchy and swollen
What is gallbladder empyema in calculous cholecystitis?
When the gallbladder is full of pus
