Flashcards in *Biliary tree and pancreas disorders 1 (Lecture 8) Deck (60)
What is the scientific name for Gallstones?
what are gallstones (cholelithiasis)?
"Hard stone-like or gravel-like material formed within the biliary system most commonly the gallbladder"
What is normal bile formed from? (4)
Micelles of cholesterol, phospholipid, bile salts and bilirubin
What is bilirubin formed from?
The breakdown of RBCs in the spleen
Where are bile salts formed?
In the hepatocytes
Where is bile formed?
In the liver
Where is bile stored and concentrated?
In the gallbladder
Where is bile released?
Into the 2nd part of the duodenum through the common bile duct and Ampulla of vater
What hormone stimulates the release of bile from the gallbladder into the the 2nd part of the duodenum?
What causes gallstones to form?
When there is an imbalance between the ratio of cholesterol to bile salts disrupting micelle formation
What are the 3 different types of gallstones that can form? - different gallstones depends on the different concentrations of constituents
When do cholesterol stones form?
When there is an excess of cholesterol in bile
What are the risk factors for the formation of cholesterol bile stones? (4)
What do cholesterol gallstones often look like?
Large and often solitary
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
Appearance of cholesterol gallstones?
Small, friable, irregular
Other than the composition of bile, what may also contribute to the formation of gallstones?
Gallbladder pH and mucosal glycoproteins
What type of gallstones are most gallstones?
In general, what problems do gallstones cause?
Infection and inflammation of the biliary lining
What conditions can gallstones cause? (10)
What is cholecystitis?
Inflammation of the gallbladder
What is cholecystitis usually associated with?
What causes acute cholecystitis?
Gallstones obstructing outflow of bile (initially sterile and then becomes infected)
What complications can acute cholecystitis cause? (4)
Intense adhesions form within 2-3 days
What leukocyte signals acute inflammation?
What is chronic cholecystitis?
Chronic inflammation of the gallbladder
What causes chronic cholecystitis?
Usually associated with gallstones - may develop insidiously or after bouts of acute cholecystitis
What is the appearance of the gallbladder in chronic cholecystitis?
Gallbladder wall is thickened (due to fibrosis) but not distended
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