Hepatobiliary Radiograph - Taylor Brown Flashcards Preview

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Flashcards in Hepatobiliary Radiograph - Taylor Brown Deck (9)
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1

Main modality of acute cholecystitis diagnosis is

Ultrasound and look for gallbladder wall thickening or edema

2

Acute choleystitis finding on US

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

3

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

4

How is biliary dyskinesia diagnosed?

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

5

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

6

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

7

what's Rigler's triad?

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

8

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

CT

9

best imaging modality for gallstone pancreatitis

- RUQ ultrasound
- ERCP