Flashcards in Biliary Tract Deck (14):
Different clinical findings of jaundice caused by CBD obstruction vs. malignancy
CBD obstruction jaundice= fluctuating intensity
malignancy jaundice= progressive
Charcots Triad Of
Cholangitis = RUQ pain, fever, jaundice
Reynolds Pentad Of
Acute cholangitis progresses to infection and pus found in bile ducts.
RUQ pain, fever, jaundice, AMS, hypoTN
TX of cholangitis
Bowel rest, IV abx, IVF, NGT if vomitting. Cholecystectomy once stable if stones were dx.
cholecystectomy within 48-72 hrs if mild-mod once inflammation has decreased.
If Severe, may need to wait weeks to months. ABX and maybe cholecystostomy or sphincterotomy with stone extraction if necc.
Actually mechanical obstruction
Test for gallstone ileus
CT w oral contrast: shows biliary-enteric fistula, air in gallbladder, intestinal obstruction, and stone
Gallstone ileus TX
NGT, IVF, surgical removal of stone, cholecystectomy and correction of fistula
Name for cancer of extrahepatic bile duct
Bile duct cancer
Name for cancer of intrahepatic bile duct
A palpable, nontender gallbladder in a jaundiced patient indicates that the site of the obstructing tumor is
Distal to cystic duct and CBD junction (mimics pancreatic head tumor presentation)
operation of choice for distal bile duct lesions
test for dx biloma
ercp or mrcp for exact location