Chapter 53: Biliary Tract- Misc Flashcards
What is a porcelain gallbladder?
- Calcified gallbladder seen on abdominal x-ray
- results from chronic cholelithiasis/cholecystitis with calcified scar tissue in gallbladder wall
- cholecystectomy required because of the strong association of gallbladder carcinoma with this condition
What is hydrops of the gallbladder?
Complete obstruction of the cystic duct by a gallstone, with filling of the gallbladder with fluid (not bile) from the gallbladder mucosa
What is Gilbert’s syndrome?
Inborn error in liver bilirubin uptake and glucuronyl transferase resulting in hyperbilirubinemia
(Think: Gilbert’s = Glucuronyl)
What is Courvoisier’s gallbladder?
- Palpable, nontender gallbladder (unlike gallstone disease) associated with cancer of the head of the pancreas
- able to distend because it has not been“scarred down” by gallstones
What is Mirizzi’s syndrome?
Common hepatic duct obstruction as a result of extrinsic compression from a gallstone impacted in the cystic duct
What is the correct diagnosis? Elderly woman with small bowel obstruction and air in the biliarytract
Gallstone ileus
38-year-old female with progressively worse RUQ pain and ultrasound reveals a thickened gallbladder wall, pericholecysticfluid, and a sonographic Murphy’s sign
Acute cholecystitis
Lap chole POD #3, fever, RUQ fluid collection, no biliary dilation
Biloma (most common cause = cystic duct leak)
POD #7 following laparoscopic cholecystectomy—jaundice anddilated intrahepatic biliary ducts
Clipping or transection of common bile duct
33-year-old woman with jaundice, fever, RUQ pain, hypotension,and confusion
Suppurative cholangitis
43-year-old woman with RUQ pain and right subscapular pain for2 hours intermittently over 4 months
Biliary colic
Name the diagnostic modality:
22-year-old with RUQ pain with eating
Ultrasound for cholelithiasis
