Abdominal: Gall stones and Bile duct stones Flashcards
(26 cards)
what is the treatment for asymptomatic gallstones?
No treatment is required
what are the two types of gallstone?
- cholesterol
2. pigment stones
what is the most common type of gallstone?
cholesterol
who is more likely to be affected by gallstones, men or women?
Women 2-3x more likely than men
what 4 factors contribute to the formation of gallstones?
- Bile contains too much cholesterol.
- Bile contains too much bilirubin.
- Gall bladder doesn’t empty correctly - bile becomes very. concentrated.
- Not enough bile salts.
what are risk factors for developing gallstones?
Gallstone Risk Factors (4 Fs)
Fat
Fair
Female
Forty
what are some clinical features of gallstones?
- biliary colic: Severe constant pain that has a crescendo characteristic.
- Initial site of pain is epigastrium but there may be a right upper quadrant component.
- Pain may radiate over the right shoulder/subscapular region.
- Nausea and vomiting may accompany the more severe attacks.
what are some clinical features of common bile duct stones?
- Biliary colic/abdominal pain.
- Fever.
- Jaundice (acute cholangitis).
what is biliary colic?
Intermittent right upper quadrant pain caused by gallstones irritating bile ducts
This pain is constant and cannot be relieved - may sometimes be triggered by fatty foods.
which other conditions present in a similar way to symptomatic gallstones?
- Acute hepatitis.
- Bile duct stricture.
- Gallbladder polyps.
- Gastritis.
- Gastro-oesophageal reflux disease.
- Inflammatory bowel disease.
- Irritable bowel syndrome.
- Non-biliary acute pancreatitis.
- Peptic ulcer disease.
- Tumours of the gallbladder, liver, stomach, gut, and pancreas.
how would you investigate and manage gallstones?
- LFTs and ultrasound
- MRCP (Magnetic Resonance Cholangio-Pancreatography) if you can’t see stones on USS
- ERPC (Endoscopic Retrograde Cholangio-Pancreatography) - Indicated for established CBD stones / obstructing ductal tumours on USS or MRCP
- Cholecystectomy
what is meant by Cholecystitis?
gallbladder inflammation
what is meant by Pancreatitis?
inflammation of pancreas
how would you treat symptomatic cholithiasis?
Laparoscopic Cholecystectomy
what are the risks of a Laparoscopic Cholecystectomy?
- bile leak
- bleeding
- infection
- injury to near by structures such as bile duct live and small intestine
- risks of general anaesthesia such as blood clots and pneumonia.
what are complications of symptomatic gallstones if left untreated?
- Cholecystitis
- Pancreatitis
- Gallbladder cancer
- Cholangitis
what is Cholangitis?
Infection and obstruction of the biliary system
A gallstone that becomes lodged in the neck of the gallbladder can cause what?
inflammation of the gallbladder (cholecystitis)
A gallstone can cause a blockage in the pancreatic duct, which can lead to what?
inflammation of the pancreas (pancreatitis)
what advice would you give to prevent gallstones?
- don’t skip meals
- eat more high fibre meals
- lose weight slowly
- maintain a healthy weight
what is meant by Cholestasis?
blockage to the flow of bile
Disorders of the liver, bile duct, or pancreas can cause cholestasis.
what is meant by Cholelithiasis?
gallstone(s) present
what is meant by Choledocholithiasis?
gallstone(s) in the bile duct
what is meant by Gallbladder empyema?
Pus in the gallbladder
