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Flashcards in Hepatobiliary Radiograph - Taylor Brown Deck (9)
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Main modality of acute cholecystitis diagnosis is

Ultrasound and look for gallbladder wall thickening or edema


Acute choleystitis finding on US

- Stones
- absence of echoes posterior to calculi ' shadowing'
- may show Thickened wall (> 4-5mm)
- may show Free fluid


If a patient presents with RUQ pain w/o radiation that starts 30 mins after eating greasy food, nausea w/o vomiting, and US shows no gallstones, sludge or microlithiasis, liver and pancreas tests are all normal, what is the likely diagnosis?

Biliary dyskinesia


How is biliary dyskinesia diagnosed?

- HIDA and PIPIDA with CCK-stimulated cholescinthigraphy indicating EF < 35-40%
- pain elicited during CCK infusion is also diagnostic


cause of gallstone pancreatitis

mechanical obstruction of hepatopancreatic ampulla causes reflex of bile into main pancreatic duct

Labs would show elevated amylase and lipase along with elevated ALT and AST


How is gallstone ileus developed?

- complication of cholelithiasis
- pericholecystic inflammation leads to development of adhesions and pressure necrosis
- gallstones enters bowel through cholecystoenteric fistual --> air in biliary tree
- stones get impacted in ileum which is the narrowest portion of intestine


what's Rigler's triad?

Seen in gallstone ileus:
- Small bowel obstruction
- gas within biliary tree
- gallstone (usually in right iliac fossa)


Diagnosis of pancreatic trauma is best done by what imaging modality?



best imaging modality for gallstone pancreatitis

- RUQ ultrasound