Flashcards in Liver and Biliary Radiography Deck (13):
acute cholecystitis- caused by? imaging?
stone obstructs the cystic duct- infl process!
-US- stones (shadowing), GB wall thickening, edema
Acute cholecystitis- complications
-gangrene, perforation, fistula
functional gallbladder disorder- HIDA scan
-CCK-induced GB ejection fraction <40%
Biliary dyskinesia- caused by? tests
-biliary pain due to a primary gallbladder motility disturbance (in absence of gallstones, sludge, microlithiasis)
-liver and pancreas tests normal
-HIDA and PIPIDA with CCK-stim cholescintigraphy- ejection fraction < 40%
-pain elicited during CCK infusion- diagnostic
Choledocholithiasis- sx, imaging
-charcot's triad- RUQ pain, fever, jaundice
-lab- common bile/hepatic duct obstruction (elevated alk phos, T bili)
-MRCP- non invasive
-ERCP- diagnostic, therapeutic
-cholangitis, obstructive jaundice, acute pancreatitis, biliary cirrhosis
Ascending cholangitis- caused by? sx?
infection of the biliary tract secondary to bile duct obstruction
-E coli, Klebsiella, Streptococcus faecalis, enterobacter, bacteroides fragilis
-Reynolds pentad- fever, jaundice, RUQ, shock, mental status changes!!
Ascending cholangitis- tx
-ERCP (but not during active phase)
-late finding- intrahepatic abscesses at duct ends!!!
-IV antibiotics and fluids
obstruction of hepatopancreatic ampulla- reflux of bile into main pancreatic duct
-elevated amylase and lipase, ALT > AST
-RUQ US, ERCP, cholecystectomy
gallstone ileus- caused by?
complication of cholelithiasis!
-infl- adhesions, pressure necrosis
-gallstone enters bowel thru cholecystoenteric fistula--> air in biliary tree!!
-stones become impacted in ileocecal valve!!
Gallstone ileus- sx
-Rigler's triad- small bowel obstruction, gas in biliary tree, gallstone!
-episodic small bowel obstruction sx as stone passes thru bowel lumen (gets stuck in ileocecal valve)
-can complicate Crohn dz
-suprarenal (adrenal) glands
-AORTA and IVC
-Duodenum (2-4th parts)
-pancreas (except tail)
-colon (asc and desc)