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Flashcards in hepatobiliary radiograph TB Deck (14):
1

what is acute cholecystitis and what are findings with it

complications

liver enzymes and bilirubin

stone obstructing the cystic duct
induces inflammatory process

-presence of stones, wall thickening (4-5mm)
-edema

complications: gangrene, perforation, cholecystoenteric fistula

liver enzymes and bilirubin normal bc no back flow into liver with cystic duct blockage

2

what is biliary dyskinesia

biliary pain resulting from a primary GB motility disturbance in absence of gallstones, sludge, microlithiasis

3

biliary dyskinesia

-liver and pancreas blood test
-test to diagnos
-symptoms relieved with what

liver and pancreas blood tests are normal

HIDA and PIPIDA with CCK stimulated cholescintigraphy indicates ejection fraction of less than 35-40%

pain elicited during CCK infusion is diagnostic

symptoms releived with cholecystectomy

4

complications with choledocholithiasis

cholangitis
obstructive jaundice
actue pancreatitis
biliary cirrhosis

5

main causes of acending cholangitis

choledocholithiasis
pancreatic/biiary neoplasm
postoperative stricture
choledocal cysts

6

bacteria in ascending cholangitis

e coli
klebsiella pneumoniiae
streptococcus faecalis
enterobacter
bacteroides fragilis

7

clinical signs of ascending cholangitis

reynolds pentad

-hyperbili
-leukocytosis
-mild elevation in serum transminases

8

what is a late finding in ascending cholangitis

intrahepatic absceses at duct ends

9

what is complication of ERCP for ascending cholangitis

perforation of duodenum
-would have history of air underneath diaphragm

10

gallstone pancreatitis

what is it
-labs
-diagnose and treat

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

-elevated serum amylase and lipase, elevated ALT>AST

-RUQ ultrasound, ERCP and cholecystectomy relieve symptoms

11

gallstone ileus

complication of cholelithiasis
pericholecystic inflammation leads to development of adhesions and pressure necrosis

-gallstone enters bowel through cholecystoenteric (cholecystoduodenal) fistula-->air in biliary tree

-50-70% of stones become impacted in the ileum

12

gallstone ileus rigler's triad
-pt present with
-can complicate

small bowel obstruction
gas within biliary tree
gallstone (usually in right iliac fossa)
-pt present with episodice small bowel obstruction symproms as stone passes
-can complicate crohn disease by obstructing disesaed segment of bowel

13

retroperitoneal structures

SAD PUCKER

Suprarenal (adrenal) glands
Aorta and IVC
Duodenum (2-4th parts)

Pancreas (except tail)
Ureters
Colon (descending and ascending)
Kidneys
Esophagus
Rectum

14

what is a common cause of retroperitoneal hematomas

pancreatic trauma