Abdominal organs

Question 1

What is the M/C positional anomaly of the gallbladder?

Answer 1

Intrahepatic gallbladder (lies between the right and left lobes of the liver)

Question 2

What are some normal gallbladder variants?

Answer 2

a. phrygian cap
b. double GB
c. left-sided GB
d. intrahepatic GB
e. agenesis of GB
f. choledocal cyst/choledochocele
g. hypoplasia and atresia of biliary tree
h. hourglass GB

Question 3

What is the classical triad associated with choledocal cyst?

Answer 3

Present in 19-60%

1) upper abdominal pain
2) abdominal mass
3) jaundice

Question 4

What is the M/C/C of acute cholecystitis?

Answer 4

gallstones (90-95%)

Question 5

Who does acute cholecystits most commonly occur in?

Answer 5

females

Question 6

What’s the M/C/C of a shrunken GB?

Answer 6

chronic cholecystitis

Question 7

What is the etiology of chronic cholecystitis?

Answer 7

Prolonged inflammation d/t intermittent obstruction of the cystic duct or infundibulum.

Question 8

What are the radiographic signs for gas filled fissures within the stone?

Answer 8

Mercedes Benz sign & crow’s feet

Question 9

What is the difference btwn pigmented and cholesterol stones in terms of calcification?

Answer 9

Pigmented stones –> central calcification

Cholesterol stones –> peripheral calcification

Question 10

Brown pigmented stones are M/C d/to?

Answer 10

E. coli

Question 11

Patients with emphysematous cholecystitis occur commonly in which patient pop’n?

Answer 11

Diabetics

Question 12

Which gender is more likely to develop emphysematous cholecystitis?

Answer 12

males (70-80%)

Question 13

Gallstone ileus is M/C seen in which demographics?

Answer 13

Female (8:1), obese, elderly

Question 14

What is strawberry GB?

Answer 14

Cholesterolosis =

Small, multiple cholesterol polyp. They have no malignant potential.

Question 15

Small diverticuli found in the mucosa wall of the gallbladder are called?

Answer 15

Rokitansky-Aschoff sinuses

Question 16

What are Rokitansky-Aschoff sinuses associated with?

Answer 16

Adenomyomatosis

smooth elevated or sessile mass found in the fundus of the GB d/t hyperplastic cholesterol

Question 17

What % of porcelain gallbladders are associated with gallstones?

Answer 17

90%

Question 18

What % of porcelain gallbladders are associated with carcinoma?

Answer 18

10-20% (some say 60%)

Question 19

What is the M/C/C of milk of calcium bile?

Answer 19

Obstruction of cystic duct (m/c by a calculus)

Question 20

What is the M/C primary carcinoma of the gallbladder?

Answer 20

Adenocarcinoma

Question 21

What is the M/C type of cholangiocarcinoma (malignant neoplasm of the bile duct)?

Answer 21

Adenocarcinoma

Question 22

Where are benign neoplasms most likely to be located in the bile duct?

Answer 22

distally (75%)

Question 23

What is the M/C benign bile duct neoplasm?

Answer 23

Papilloma (M/C multiple) & adenoma (M/C single)

Question 24

Which tumor arises at the junction of the R and L hepatic ducts?

Answer 24

Klatskin’s tumor

Question 25

What is the 2nd M/C primary malignant tumor of the liver?

Answer 25

Klatskin's tumor

Question 26

What is Caroli's disease?

Answer 26

Familial cause - multifocal saccular dilatations of the INTRAHEPATIC bile ducts. Classified as a type V choledochal cyst.

Question 27

What is Sclerosing Cholangitis?

Answer 27

Idiopathic inflammatory condition affecting the biliary tree resulting in multiple strictures and eventual cirrhosis.

Question 28

What is Mirizzi syndrome?

Answer 28

Extrinsic compression of an extra-hepatic billiary duct from one or more calculi within the cystic duct or gallbladder.

Question 29

What is a choledochocele?

Answer 29

Cystic dilatation of the intraduodenal portion of the common bile duct in the region of the ampulla of Vater.

Question 30

What common normal variant presents as an elongated/extension of the right lower lobe of the liver?

Answer 30

Riedel's lobe

Question 31

What are 2 types of jaundice?

Answer 31

Non-obstructive = d/t overproduction or lack of liver to excrete the bile. Obstructive = d/t blockage of flow of bile out of the liver.

Question 32

What are 3 causes of portal hypertension?

Answer 32

1. Block in the intrahepatic portal vein 2. Increased bloodflow to the liver 3. Heart failure causing venous hypertension

Question 33

What is Budd-Chiari syndrome?

Answer 33

Thrombotic or non-thrombotic obstruction of the hepatic venous outflow -- characterized by hepatomegaly, ascites, and abdominal pain.

Question 34

What is the M/C benign liver neoplasm?

Answer 34

Hemangioma

Question 35

What is the gold standard imaging modality for a liver hemangioma?

Answer 35

Angiography

Question 36

How does a liver hemangioma present on US?

Answer 36

Hyperechoic mass in 80%

Question 37

Hepatocellular carcinoma is more commonly seen patients with what other liver conditions?

Answer 37

Cirrhotic livers or chronic hepatitis

Question 38

What is the M/C anomaly of the pancreas?

Answer 38

Ectopic pancreatic tissue