Lesson 2B (Part 1) Flashcards Preview

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Flashcards in Lesson 2B (Part 1) Deck (24)
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1

What is acute bacterial cholangitis?

Its an antecedent biliary obstruction

2

What is acute bacterial cholangitis caused by? (4)

1. CBD stones
2. Stricture due to trauma or surgery
3. Choledochal cysts
4. Partially obstructive tumors

3

What are signs and symptoms of acute bacterial cholangitis?(3)

1. Fever
2. RUQ pain
3. Jaundice

4

What are the signs and symptoms fever, RUQ pain and jaundice known as?

Classic Charcot’s Triad

5

What can acute bacterial cholangitis cause? (3)

1. Leukocytosis
2. Increase levels of ALP and bilirubin
3. Gram-negative enteric bacteria in blood

6

What is the sonographic appearance of acute bacterial cholangitis? (7)

1. Dilation of intrahepatic biliary tree
2. Choledocholithiasis
- stone in distal CBD
3. CBD wall thickening
4. Hepatic abscess
5. Dilated CBD >6mm
6. Pneumobilia
- suggests a fistula-choledochoenteric
7. Gallbladder wall may be thickened

7

Fasioliasis

Parasitic flatworms that travel through bowel wall and into the peritoneal cavity to the liver capsule into liver parenchyma to cause an infection

8

What do fascioliasis do?

Matures and produces eggs in the biliary tree

9

What are the symptoms of fascioliasis? (3)

1. Jaundice
2. Fever
3. Abscess

10

What is the sonographic appearance of fascioliasis? (3)

1. Hepatomegaly
2. Hilar adenopathy
3. Lesions
- hypoechoic or mixed echogenicity

11

Where can flukes be seen? (2)

1. Within ducts
2. Within the gallbladder

12

Clonorchiasis and Opisthorchiasis

Larvae that migrate through the Ampulla of Vater into the CBD

13

Where does clonorchiasis and opisthorchiasis mature?

Within the intrahepatic bile ducts

14

What is the sonographic appearance of clonorchiasis and opisthorchiasis? (3)

1. Diffuse dilation of the peripheral intrahepatic ducts
2. Periportal echoes
- edema (excess of watery fluids)
3. Floating echogenic foci in gallbladder
- flukes or debris

15

What is ascariasis?

Roundworm that causes infection in the small bowel
- enters the biliary tree via the Ampulla of Vater

16

Who is ascariasis spread?

Fecal-oral route

17

Where do is ascariasis active?

In small bowel, then enters the biliary tree via the Ampulla of Vater

18

What is the sonographic appearance of ascariasis? (3)

1. Appears as a tube or parallel echogenic lines within bile ducts or GB
2. Worm moves during US
3. May be multiple

19

Primary sclerosing cholangitis

Chronic inflammatory disease of entire biliary tree that slowly damages the bile ducts

20

Who is primary sclerosing cholangitis more frequent in?

Men
- around the age of 39

21

What is the cause of primary sclerosing cholangitis?

Unknown
- however, 80% of patients have inflammatory bowel disease (colitis)

22

What does primary sclerosing cholangitis lead to? (5)

1. Biliary strictures
2. Cholestasis
3. Biliary cirrhosis
4. Portal hypertension
5. Hepatic failure

23

What causes secontary sclerosing cholangitis? (10)

1. AIDS cholangiopathy
2. Bile duct neoplasm
3. Biliary tract surgery
4. Trauma
5. Choledocholithiasis
6. Congenital anomalies
7. Ischemic stricturing of bile ducts
8. Toxic strictures
- infusion of fluxuridine
9. Post treatment for hydatid cyst
10. Primary sclerosing cholangitis

24

What does secondary mean?

That it is caused by something else