Flashcards in Hepatobiliary Radiograph - Taylor Brown Deck (9)
Main modality of acute cholecystitis diagnosis is
Ultrasound and look for gallbladder wall thickening or edema
Acute choleystitis finding on US
- 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?
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?