Biliary System

Question 1

Which ducts join to form the CHD?

Answer 1

right and left hepatic ducts

E 40

Question 2

Which ducts join to form the CBD?

Answer 2

cystic duct and CHD

E 40

Question 3

Which ducts join to form the ampulla of Vater?

Answer 3

CBD and Duct of WIrsung in the pancreas

E 40

Question 4

What does the portal triad consist of?

Answer 4

MPV
CHD
proper HA
E 40

Question 5

What do the valve of Heister’s control?

Answer 5

controls the bile flow in the cystic duct

E 41

Question 6

What is Hartmann’s pouch?

Answer 6

abnormal sacculation of the neck of the GB

E 41

Question 7

What is a phrygian cap?

Answer 7

fold between the body and fundus

E 41

Question 8

What is a junctional fold?

Answer 8

fold between the body and neck

E 41

Question 9

Where does the ampulla of Vater empty into?

Answer 9

passes through the sphincter of Oddi into the duodenum

E 41

Question 10

What is normal GB wall thickness?

Answer 10

less than 3 mm

E 42

Question 11

What are causes of GB wall thickening?

Answer 11

Cholecysitis
hypoalbuminemia
ascites
hepatitis
congestive heart failure
pancreatitis
E 43

Question 12

What is sludge associated with?

Answer 12

biliary stasis
prolonged fasting 
hemolysis
cystic duct obstruction
cholecystitis
E 43

Question 13

What is a gallbladder filled with stones called?

Answer 13

WES sign

E 44

Question 14

What features are present with acute cholecystitis?

Answer 14

gallstones
Murphy's sign
diffuse wall thickening
gallbladder dilitation 
sludge
E 45

Question 15

What is considered chronic cholecystitis?

Answer 15

history of multiple episodes of acute cholecystitis, sonographically the same as acute cholecystitis
E 45

Question 16

What is emphysematous cholecystitis?

Answer 16

acute cholecystitis due to wall ischemia and infection

E 46

Question 17

What is empyema of the gallbladder?

Answer 17

pus within the gallbladder

E 47

Question 18

What is gallbladder perforation?

Answer 18

localized fluid collection in the gb fossa

E 47

Question 19

What is acalculous cholecystitis?

Answer 19

acute cholecystitis without gallstones

E 48

Question 20

What is a porcelain gallbladder?

Answer 20

calcification of the gallbladder wall

E 49

Question 21

What is hydrops of the gallbladder?

Answer 21

overdistended gb
asymptomatic
E 49

Question 22

What size of gallbladder polyps are considered benign?

Answer 22

< 10 mm

E 49

Question 23

What is cholesterolosis?

Answer 23

lipids deposited into the gallbladder wall appearing like polyps
E 50

Question 24

What are the sonographic findings of gallbladder carcinoma?

Answer 24

intraluminal mass
asymmetric wall thickening
mass that fills the gb
E 50

Question 25

What is adenomyomatosis?

Answer 25

hyperplastic changes involving the gallbladder wall forming a thickened wall and diverticula E 51

Question 26

What artifact is associated with adenomyomatosis?

Answer 26

comet-tail (reverberation) | E 51

Question 27

Where in the biliary tract is biliary obstruction most common?

Answer 27

distal CBD | E 52

Question 28

What are the 2 most common reasons for biliary obstruction?

Answer 28

gallstones carcinoma of the head of the pancreas E 52

Question 29

Obstruction of the biliary tract would elevate which lab values?

Answer 29

alk phos bilirubin E 52

Question 30

What is a normal measurement of the CBD postcholecystectomy?

Answer 30

up to 10 mm | E 53

Question 31

What is it called when the dilated hepatic duct is parallel to the portal vein?

Answer 31

Shotgun sign | E 54

Question 32

What is choledocholithiasis?

Answer 32

calculi present in the bile ducts | E 56

Question 33

What are symptoms of choledocholithiasis?

Answer 33

RUQ pain jaundice E 56

Question 34

What is Mirizzi Syndrome?

Answer 34

extrahepatic biliary obstruction due to a stone in the cystic duct E 56

Question 35

What is a common finding with cholangiocarcinoma?

Answer 35

intrahepatic dilatation | E 57

Question 36

What is cholangitis?

Answer 36

bacterial infection caused from obstruction of the biliary tree.

Question 37

When is biliary atresia suspected?

Answer 37

when jaundice persists beyond 14 days old | E 58

Question 38

What is pneumobilia?

Answer 38

air in the biliary tract | E 58

Question 39

What findings are seen with pneumobilia?

Answer 39

echogenic foci with comet-tail reverberation | E 59

Question 40

What is a choledochal cyst?

Answer 40

cystic dilitation of the bile ducts | E 59

Question 41

What are the sonographic findings of choledochal cysts?

Answer 41

two cystic structures in the GB and CBD | E 59

Question 42

What is Caroli's disease?

Answer 42

congenital anomaly where there is dilitation of the intrahepatic ducts E 60

Question 43

What are the sonographic findings in Caroli's disease?

Answer 43

multipe cystic structures that converge towards the porta hepatis communitcating with the bile ducts sludge and calculi can be seen E 60

Question 44

What is courvoisier gallbladder?

Answer 44

enlarged non-diseased GB due to obstruction of the CBD | E 60

Question 45

What lab value is elevated in biliary disease?

Answer 45

conjugated bilirubin and alk phos | E 62