Biliary tree disease - Week 7 Flashcards
What are the 3 types of gallstones?
Mixed, Cholesterol and Pigment
What is the most common type of gallstone?
Mixed
Give some risk factors for gallstones.
Age > 40 Female High fat diet Obesity Pregnancy Hyperlipidaemia Bile salt loss (Crohn’s) Diabetes Dysmotility of GB Prolonged fasting TPN
What is meant by biliary colic?
Stone impacts in cystic duct
Describe the pain associated with biliary colic.
Gradual build-up pain in RUQ
Radiates to back / shoulder
May last 2-6 hours
Biliary colic may be associated with…
indigestion / nausea
Give some differential diagnoses of severe acute epigastric pain.
Biliary colic Peptic ulcer disease Oesophageal spasm Myocardial infarction Acute pancreatitis
What is meant by Acute cholecystitis?
Inflammation in Gall Bladder - Obstruction of Cystic duct
How are gallstones diagnosed?
Ultrasound
CT scan
MRCP / ERCP
What is the treatment of acute cholecystitis?
IV antibiotics and IV fluids
Nil by mouth
US to confirm diagnosis
Urgent cholecystectomy
Which procedure doubles as diagnostic and treatment?
ERCP
Give 2 common causes of acute pancreatitis.
Alcohol, gallstones
What is meant by gallstone ileus?
Small bowel obstruction –
gallstone impacted in distal ileum
How is gallstone ileus treated?
Urgent Laparotomy
What is meant by cholecystitis?
Inflammation of the gallbladder
