Flashcards in Gallstones Deck (24):
List risk factors for gallstones
OCP/ estrogen therapy
rapid weight loss
Hemolysis causes _______ gallstones
Jaundice due to hemolytic anemia causes what changes in bilirubin levels?
Greater increase in unconjugated than conjugated bilirubin
Jaundice due to hepatitis causes what changes in bilirubin levels?
Similar increase in both conjugated and unconjugated bilirubin
Jaundice due to biliary duct stone causes what changes in bilirubin levels?
Greater increase in conjugated than unconjugated bilirubin
Bile is composed of:
Water, Bile acids, Phospholipids, Electrolytes, Cholesterol, Bilirubin
List three key features of biliary stone formation
List 6 conditions/ clinical manifestations of biliary stone formation
1) Symptomatic cholelithiasis
2) Acute cholecystitis
3) Chronic cholecystitis
5) Gallstone pancreatitis
What is the treatment for symptomatic cholelithiasis?
How is acute cholecystitis diagnosed on MRI?
thickened gall bladder wall, pericholecystic fluid
What is the treatment for acute cholecystitis?
What are possible outcomes if cholecystectomy is not performed on a patient with acute cholecystitis?
Describe the presentation of chronic cholecystitis
post-prandial RUQ pain, nausea
fibrotic/ thickened gallbladder wall due to chronic irritiation
invariably associated with cholelthiasis
How is chronic cholecystitis treated
It is important to recognize porcelain gallbaldder because of the significant risk of _______
What is choledocholithiasis?
gallstones in duct, can occur even after cholecystectomy
What is the treatment for choledocholithiasis?
ERCP with stone extraction, sphincterotomy
What are possible complications of choledocholithiasis?
Describe the presentation of gallstone pancreatitis
severe constant epigastric pain radiating to back
elevated WBCs, elevated bilirubin/ ALKP/ ALT/AST/ amylase/ lipase
CT with peri-pancreatic inflammation, dilated bile ducts, cholelithiasis
What is the treatment for gallstone pancreatitis?
IV fluids and medically stabilize
ERCP stone extraction
List key symptoms that suggest acute cholangitis
RUQ pain, fever, jaundice, hypotension, mental status changes
Describe the findings seen in acute cholangitis
Elevated WBCs, LFTs
MRCP shows common bile duct full of stones, obstruction of biliary tree, and purulent fluid filling biliary tree
List bacteria commonly implicated in acute cholangitis
E coli, Klebsiella, Enterobacter species