18-9: Gallbladder Flashcards
what is the most common congenital anomaly associated with the gallbladder?
a folded fundus creating a phrygian cap
what are the two classes of gallstones?
cholesterol stones
pigment stones
which type of stones is more prominent in the US?
cholesterol stones
where are pigment stones more prominent?
non-Western populations in the setting of bacterial or parasitic infections of the biliary tree
what are the risk factors for cholelithiasis?
Family hx Fair skinned Fat Forty Female Fertile
what is the clinical presentation of cholelithiasis?
RUQ pain after a fatty meal
pain may radiate to the right shoulder or back
what severe complications are associated with cholelithiasis?
empyema perforation fistula cholangitis obstructive cholestasis pancreatitis ****gallbladder carcinoma****
what is the relationship between size of the stone and risk of complication?
the smaller the stone, the greater the risk of obstruction
what is Bouveret syndrome?
a large stone that erodes directly into an adjacent loop of small bowel, causing intestinal obstruction
what is acute cholecystitis?
inflammation of the gallbladder caused by obstruction of the neck or cystic duct by a stone
what is the clinical presentation of cholecystitis?
possible hx of "prior attacks" progressive RUQ or epigastric pain for 6 hours mild fever anorexia tachycardia sweating N/V
if a patient is diagnosed with cholecystitis and has jaundice, where is the obstruction located?
common bile duct
what lab values are associated with cholecystitis?
mild to moderate leukocytosis
mild elevation in alk phosphatase
what is acalculous cholecystitis?
inflammation of the gallbladder without stone obstruction
acalculous cholecystitis is associated with an increased risk of what compared to calculous cholecystitis?
gangrene
perforation
