Hepatobiliary Disease Flashcards
(29 cards)
What is acute cholecystitis?
Gallstone blocking CYSTIC DUCT OF NECK OF GALLBLADDER causing local inflammation (unlikely to be an infection).
What type of pain is experienced with acute cholecystitis?
Prolonged severe epigastric/RUQ pain.
What are some associated symptoms of acute cholecystitis?
Fever, guarding, positive Murphy’s sign.
Leucocytosis.
What is biliary colic?
Gallstone blocking the BILE DUCT.
What type of pain is experienced with biliary colic?
Intermittent (lasting <6hrs), intense dull epigastric pain associated with eating.
Radiates to back and shoulder blades.
What are some associated symptoms of biliary colic?
N&V, sweating.
What is acute ascending cholangitis?
Stones become impacted in BILIARY or HEPATIC ducts, leading to dilation of duct and hence bacterial infection.
What bacteria most commonly causes acute ascending cholangitis?
E. Coli.
What are some associated symptoms of acute ascending cholangitis?
CHARCOT’S TRIAD - fever, jaundice, RUQ pain.
Can also get confusion and hypotension (biliary sepsis).
What is Charcot’s Triad and what condition is it associated with?
Fever, jaundice, RUQ pain.
Acute Ascending Cholangitis.
What is primary sclerosing cholangitis?
A chronic inflammatory condition that leads to fibrosis and destruction of intra- and extra-hepatic bile ducts. Ultimately this leads to stricturing and cirrhosis.
What are some associated symptoms of primary sclerosing cholangitis?
Pruritus, jaundice, fatigue, weight loss, RUQ pain.
Ulcerative colitis.
What does ERCP show in primary sclerosing cholangitis?
Multiple biliary strictures giving a ‘beaded appearance’.
What group of people are more likely to suffer from primary sclerosing cholangitis?
Those with ulcerative colitis.
What is primary biliary cholangitis/cirrhosis?
Autoimmune destruction of the bile ducts, hence bile builds up in liver which leads to cirrhosis.
In which population is primary biliary cholangitis/cirrhosis most commonly seen?
Middle-aged females.
What are some associated symptoms of primary biliary cholangitis/cirrhosis?
Fatigue, pruritus.
What does a positive Murphy’s sign support a diagnosis of?
Acute cholecystitis.
What are some possible complications of acute cholecystitis?
Abscess, perforation, fistulae.
What type of pain is experienced with acute ascending cholangitis?
Severe, continuous epigastric/RUQ pain.
What are gallstones and what are they made of?
Formation of stones within the bile as a result of excess cholesterol. They are made of bile salts, phospholipids and cholesterol.
What are the different compositions of gallstones?
Stones can be:
- Pure cholesterol (often large solitary, 10%).
- Pure pigment (10%).
- Mixed (often multiple stones, 80%).
What imaging technique is used to investigate gallstones?
USS.
What are some possible complications of gallstones?
Pancreatitis.
Choledocholithiasis (gallstones in CBD).
Biliary sepsis.
