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KaBoom > Biliary System - Part 3 > Flashcards

Biliary System - Part 3 Flashcards

1
Q

What is the cause of biliary dilatation?

A

Biliary obstruction

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2
Q

What are the clinical findings of biliary dilatation? (4)

A
  1. Asymptomatic
  2. RUQ pain
  3. Jaundice
  4. Elevated direct bilirubin and alkaline phosphatase
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3
Q

What is the US appearance of biliary dilatation? (3)

A
  1. Dilated intrahepatic and/or extrahepatic bile ducts
  2. Parallel channeling
  3. Portal vein may appear flattened
    with progressive dilatation
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4
Q

What are 2 differential diagnosis for biliary dilatation?

A
  1. Normal biliary tree

2. Portal hypertension

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5
Q

What causes biliary atresia? (2)

A
  1. Congenital anomaly

2. Viral infection

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6
Q

What are 4 complications of biliary atresia?

A
  1. Death
  2. Cirrhosis
  3. Cholangitis
  4. Portal hypertension
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7
Q

What is the clinical finding of biliary atresia?

A

Persistent jaundice

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8
Q

What is the US appearance of biliary atresia? (4)

A
  1. Absent hepatic biliary radicles
  2. Small or absent GB
  3. Absent CHD
  4. Hepatomegaly
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9
Q

What are 2 differential diagnosis for biliary atresia?

A
  1. Normal biliary tree

2. Hepatitis

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10
Q

What are the causes of hemobilia? (3)

A
  1. Liver biopsy
  2. Trauma
  3. Vascular malformation
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11
Q

Hemobilia

A

Blood in the biliary tree

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12
Q

What are the clinical findings for hemobilia? (2)

A
  1. Abdominal pain
  2. Hematemesis
    - vomiting blood
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13
Q

What is the US appearance for hemobilia? (2)

A
  1. Low-level echoes within the bile ducts

2. Gravity dependent

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14
Q

What are 2 differential diagnosis for hemobilia

A
  1. Technical error

2. Cholangitis

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15
Q

Pneumobilia

A

Presence of gas in the biliary system

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16
Q

What can cause pneumobilia? (4)

A
  1. Surgical procedure
  2. Trauma
  3. Infection
  4. Incompetent
    sphincter of Oddi
17
Q

What are the clinical findings of pneumobilia? (2)

A
  1. Asymptomatic

2. RUQ pain

18
Q

What is the US appearance of pneumobilia? (3)

A
  1. Hyper echoic focus(i) in the intrahepatic bile ducts

2. Comet-tail reverberation artifact 3. Often centrally located

19
Q

What are 3 differential diagnosis for pneumobilia?

A
  1. Foreign body
  2. Biliary calculus
  3. Arterial calcification
20
Q

What are the clinical findings of Caroli disease? (4)

A
  1. Abdominal pain
  2. Abdominal cramping
  3. Fever
  4. Intermittent jaundice
21
Q

What is the US appearance of Caroli disease? (2)

A
  1. Segmental, saccular, or beaded appearance of the intrahepatic bile ducts
  2. Multiple cystic structures in the liver that communicate with the biliary tree
22
Q

What are 2 differential diagnosis for Caroli disease? (2)

A
  1. Polycystic liver disease

2. Biliary obstruction

23
Q

What is clonorchiasis caused by?

A

Ingestion of raw freshwater fish

24
Q

Clonorchiasis

A

Infectious disease

25
What are the clinical findings for clonorchiasis? (3)
1. RUQ pain 2. Fever 3. Leukocytosis
26
What is the US appearance for clonorchiasis? (3)
1. Dilatation of the intrahepatic bile ducts 2. Diffuse thickening of the bile duct walls 3. Echogenic focus within the bile duct
27
What are 2 differential diagnosis for clonorchiasis?
1. Cholangitis | 2. Cholangiocarcinoma
28
Klatskin tumour
Is a cholangiocarcinoma occurring at the confluence of the right and left hepatic bile ducts
29
What are the clinical findings of Klatskin tumour? (6)
1. Jaundice 2. Acute onset of abdominal pain 3. Biliary colic 4. Weight loss 5. Elevated bilirubin and alkaline phosphatase levels 6. Mild increase in AST and ALT levels
30
What is the US appearance of Klatskin tumour? (3)
1. Small echogenic mass near the hepatic hilum 2. Dilatation of the intrahepatic bile ducts 3. Normal extrahepatic bile ducts
31
What are 4 differential diagnosis for Klatskin tumour?
1. Artifact 2. . Portal vein thrombosis 3. Hepatic tumour 4. Lymphadenopathy

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