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Flashcards in Biliary Surgery Definitions Deck (40)
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1
Q

Cholelithiasis

A

gallstones visualized in study

2
Q

gallbladder sludge

A

thicker than bile, not as firm; falls apart unlike a stone (enough to cause symptoms)

3
Q

porcelain gallbladder

A

calcium deposits in the wall–>seen on plain xray

4
Q

gallbladder polyps

A

densities within the gallbladder that doesnt move when the patient moves; a stone will roll around but polyp will stay still

5
Q

wall thickening

A

gall bladder wall itself, very subjective occasionally measured (accuracy is questionable)
should be no more than 2-3 mm thick normally
implies inflamed GB or possible malignancy (but rare)

6
Q

Biliary Colic

A

RUQ pain but no stones in GB, when contracts not able to contract thoroughly and increase pressure causes pain

7
Q

cholecystitis, acute or chronic

A

inflammation of the Gall bladder; 24 hours vs months
implies with stones unless you use Acalculous
note: can have acute episode with chronic pathology

8
Q

acute acalculous cholecystitis

A

no GB stones in the inflammation

not often but can still call for gall bladder removal

9
Q

acute emphysematous cholecystitis

A

gas or air within wall of the gall bladder–> BAD
can indicate a gas forming infection
show up on Xray
pneumobilia- air within the biliary tree

10
Q

acute gangrenous cholecystitis

A

often preceded by acute emphysematous cholecystitis
loss of its blood supply and its dead
blackish bluish color
often leads to perforation (mortality around 50%)

11
Q

Hydrops

A

enlargement of the gallbladder
blockage of the bile in or out
changes to not pigmented clear snotty fluid
can only make this diagnosis via ASPIRATION or during surgical removal

12
Q

choledocholithiasis

A

stone has passed out of GB and into bile duct or biliary tree
cause similar symptoms to cholecystitis
can block ampulla to the doudenum

13
Q

cholangitis

A

infection from the bile duct (Ascending)

  • charcot’s triad
  • reynold’s pentad
14
Q

Mirizzi’s Syndrome

A

large stone in cystic duct before it gets into common duct, but it is so large it compresses/blocks the common bile duct
-not seen very often

15
Q

gallstone pancreatitis

A

into common bile duct through ampullas or impacted in ampula, also blocks pancreatic duct

16
Q

Gallstone ileus

A

“bullseye” in RLQ on Xray if calcified (5%)
in intestine creating a fistula ; ileocecal valve is smallest area where it usually gets stuck
-can present as a bowel obstruction and pain is generally not as severe

17
Q

Choledochal cyst

A

cystic formation of biliary tree; multiple forms;congenital

  • jaundice especially if child
  • dont drain properly
  • increased risk to form malignancy later in life
18
Q

gall bladder carcinoma

A

not very common

  • polyps can be indications
  • stones for a long time increase risk
19
Q

obstructive jaundice

A

blockage of bile duct (surgery needed) - bile can not get from Liver to GI tract or an increase bile production

20
Q

nonobstructive jaundice

A

something is wrong with liver; not releasing bile (not-surgical)

21
Q

murphy’s sign

A

doesnt have to be GB 100% of time - just keep that in mind

22
Q

courvoisier’s sign

A

non tender palpable mass RUQ

BAD sign–> can indicate malignancy usually from bile duct obstruction

23
Q

Cholecystectomy

A

=removal of the gallbladder
most are done laparoscopically
common procedure

24
Q

cholecystotomy

A

make a hole in the gallbladder or place a drainage tube (invasive radiologist)

25
Q

common bile duct exploration

A

can be done open or laparoscopically

26
Q

intraoperative cholangiogram

A

X ray done during surgery

checks for stones in the biliary tree

27
Q

Endoscopic retrograde cholangiopancreatography (ERCP)

A

scope, usually done by GI doc

different than standard GI scope

28
Q

Radionuclide scope (HIDA)

A

Isotope filtered by liver then drained by bile

pictures of liver, bile ducts, and gall bladder, taken as isotope makes its way down

29
Q

Triangle of Calot

A

edge of liver, cystic duct, common duct; lymph node within called node of calot
cystic artery within the triangle

30
Q

spiral valves of heister

A

spiral-shaped anatomy explains why stones can get hung up in ducts
in cystic duct; folds in the submucosa

31
Q

Hepatoduodenal ligament

A

lower part of the GB connected to the infundibulum.

contains portal triad

32
Q

Common patient presentation of cholecystitis

A

RUQ/epigastic pain that radiates to Right SCAPULAR area
lasts a few hours
food related (especially fatty foods or spicy)
N/V
Diaphoresis, fever with obstruction maybe
anxious-pacing
Nothing helps time and potent analgesics

33
Q

GERD

A

radiation directly into back
worse with recumbent position
EGD/UPGI
antacids

34
Q

Pancreatitis patient presentation

A

radiates directly into back
helps to lean forward
amylase/lipase increased
CT SCAN

35
Q

Appendicitis

A
shorter history 
requires RUQ appendix position (can start in umbilical region and then moves)
no food relationship
Rovsing
CT scan
36
Q

Myocardial infarction

A

Vascular Hx
EKG
Cardiac enzymes

37
Q

Right lobe (lower) pneumonia

A
Fever, cough SOB
smoking
debilitation
lung sounds
CXR
38
Q

pyelonephritis

A

fever, Lloyds sign, UA

39
Q

Charcots Triad

A

RUQ pain, fever, Jaundice (Acute cholangitis relevance)

40
Q

Reynolds Pentad

A

Charcots Triad (jaundice, RUQ pain, fever) plus hypotension and mental confusion