Flashcards in *Biliary tree and pancreas disorders 1 (Lecture 8) Deck (60)
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1
What is the scientific name for Gallstones?
Cholelithiasis
2
what are gallstones (cholelithiasis)?
"Hard stone-like or gravel-like material formed within the biliary system most commonly the gallbladder"
3
What is normal bile formed from? (4)
Micelles of cholesterol, phospholipid, bile salts and bilirubin
4
What is bilirubin formed from?
The breakdown of RBCs in the spleen
5
Where are bile salts formed?
In the hepatocytes
6
Where is bile formed?
In the liver
7
Where is bile stored and concentrated?
In the gallbladder
8
Where is bile released?
Into the 2nd part of the duodenum through the common bile duct and Ampulla of vater
9
What hormone stimulates the release of bile from the gallbladder into the the 2nd part of the duodenum?
Cholecystokinin (CCK)
10
What causes gallstones to form?
When there is an imbalance between the ratio of cholesterol to bile salts disrupting micelle formation
11
What are the 3 different types of gallstones that can form? - different gallstones depends on the different concentrations of constituents
Cholesterol stones
Pigement stones
Mixed stones
12
When do cholesterol stones form?
When there is an excess of cholesterol in bile
13
What are the risk factors for the formation of cholesterol bile stones? (4)
Female gender
Obesity
Diabetes
Genetics
14
What do cholesterol gallstones often look like?
Large and often solitary
15
When do pigment stones form?
What can cause this (risk factor)?
When excess bilirubin cannot be solubilised in bile salts
Excess haemolysis e.g. haemolytic anaemia
16
Appearance of cholesterol gallstones?
Small, friable, irregular
17
Other than the composition of bile, what may also contribute to the formation of gallstones?
Gallbladder pH and mucosal glycoproteins
18
What type of gallstones are most gallstones?
Mixed
19
In general, what problems do gallstones cause?
Infection and inflammation of the biliary lining
20
What conditions can gallstones cause? (10)
Acute cholecystitis
Chronic cholecystitis
Mucocoele
Empyema
Carcinoma
Ascending cholangitis
Obstructive jaundice
Gallstone ileus
Acute pancreatitis
Chronic pacnreatitis
21
What is cholecystitis?
Inflammation of the gallbladder
22
What is cholecystitis usually associated with?
Gallstones
23
What causes acute cholecystitis?
Gallstones obstructing outflow of bile (initially sterile and then becomes infected)
24
What complications can acute cholecystitis cause? (4)
Empyema
Rupture
Peritonitis
Intense adhesions form within 2-3 days
25
What leukocyte signals acute inflammation?
Neutrophils
26
What is chronic cholecystitis?
Chronic inflammation of the gallbladder
27
What causes chronic cholecystitis?
Usually associated with gallstones - may develop insidiously or after bouts of acute cholecystitis
28
What is the appearance of the gallbladder in chronic cholecystitis?
Gallbladder wall is thickened (due to fibrosis) but not distended
29
What are Rokitansky-Aschoff sinuses?
Histologically, they are outpouchings of gallbladder mucosa into the gallbladder muscle layer and subserosal tissue as a result of hyperplasia and herniation of epithelial cells through the fibromuscular layer of the gallbladder wall. They are usually referred to as adenomyomatosis - usually due to increased pressure and recurrent damage of the gallbladder wall
30
