Hepatobiliary Flashcards
(45 cards)
What are the three types of clinical indications of a hepatobilliary pathology?
Unexplained – weight loss – pain – right upper quadrant
Gallstones > Blockages/obstruction - severe illness + jaundice
Tumours - Pancreas + duodenum > prevent flow of bile to the duodenum
What is cholecysitis?
Inflammation of gallbladder - painful RUQ
What is the cause of cholecysitis?
Gallstones
What is the treatment of cholecysitis?
Pain relief – antibiotics – fluids
The gallbladder can be removed to prevent further attacks (laparoscopic cholecystectomy)
How are gallstones formed and what are they made of?
Substances reach the limit of solubility – mix with bile sludge – Stone is formed
The two main substances – cholesterol + calcium bilirubinate
What is the most common cause of digestive disease?
Gallstones
What is the incidence m v. w of gallstones?
Women are 2 to 3 times more likely than men during their reproductive years
What are the risk factors for gallstones?
Being over 40 to 60
Pregnancy
overweight or obese
sedentary lifestyle
high sat fat diet
 what colour are the different stones in relation to their composition?
Cholesterol stones – yellow
Calcium, Bilirubin + pigment gallstones – black/brown
What are the signs and symptoms of gallstones?
Biliary colic/RUQ pain
Attacks occur after eating – especially high saturation meals
Intense pain behind shoulder
Possible vomiting
jaundice due to non excretion of bilirubin
What are the complications of gallstones?
Blocked duct at ampulla of vatar
Bile may back up into liver – infected
Biliary obstruction – jaundice
Severe pain and inflammation– cholecysitis
Pancreatitis
Start capacitor the duodenum – Balance duction – gallstone Ileus
What is jaundice?
Yellowing of skin (eyes) from accumulated Billirubin in the skin – is itchy and uncomfortable
What is obstructive jaundice?
Failure of excretion of BilliRubin biliary system
What is the cause of obstructive jaundice?
Gallstones
Cancer – especially at head of pancreas – may give rise to jaundice
Lactogenic obstruction usually secondary to surgery
What is the treatment of gallstones?
Surgery – Laparoscopic/keyhole – gallbladder is not essential organ for life – cholestectomy
Active monitoring +/- Pain relief
Balance diet – eat well plate
Stones removed by ERCP or PTC
Medication to dissolve stones
What imaging is used for imaging gallstones?
X-ray – if the composition has a high calcium
Ultrasound – this is the number one modality
CT
ERCP
What is ERCP and its complications?
Endoscopic retrograde cholangiopancreatography
Complications: (gallstone)
Sepsis
Haemorrhage
Perforation – by leak
death
What modalities does the pancreas show up on?
CT and MRI
Difficult organ to image with plain radiography
What is pancreatitis?
Inflammation of the pancreas, cause by activation of pancreatic enzymes in the pancreas is post to the duodenum
What are the clinical indication/symptoms of acute Pancreatitis?
 severe abdominal pain
Infection
Internal bleeding
Life threatening
Fever or jaundice
What is chronic Pancreatitis?
Slow
Insert
Gradual destruction of pancreas
What is the cause of chronic pancreatitis
And what can it lead to?
Most common alcoholism but could be gallstones
can lead to type two diabetes pancreatic insufficiency and pancreatic cancer
What is the aetiology of pancreatitis?
75% linked to obesity and alcohol
Alcohol abuse
Trauma to pancreas
Blockage of pancreatic duct
Blockage of common bile duct
Autoimmune response
Increase fat levels in blood

Imaging of pancreatitis?
Ultrasound to determine gallstones
CT is a choice in the diagnosis and staging of acute pancreatitis and it’s complications
