Liver and Biliary Radiography Flashcards Preview

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Flashcards in Liver and Biliary Radiography Deck (13):
1

acute cholecystitis- caused by? imaging?

stone obstructs the cystic duct- infl process!
-US- stones (shadowing), GB wall thickening, edema

2

Acute cholecystitis- complications

-gangrene, perforation, fistula

3

functional gallbladder disorder- HIDA scan

-CCK-induced GB ejection fraction <40%

4

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

5

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

6

Choledocholithiasis- complications

-cholangitis, obstructive jaundice, acute pancreatitis, biliary cirrhosis

7

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!!

8

Ascending cholangitis- tx

-ERCP (but not during active phase)
-late finding- intrahepatic abscesses at duct ends!!!
-IV antibiotics and fluids

9

gallstone pancreatitis

obstruction of hepatopancreatic ampulla- reflux of bile into main pancreatic duct
-elevated amylase and lipase, ALT > AST
-RUQ US, ERCP, cholecystectomy

10

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!!

11

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

12

retroperitoneal structures

SADPUCKER
-suprarenal (adrenal) glands
-AORTA and IVC
-Duodenum (2-4th parts)
-pancreas (except tail)
-ureters
-colon (asc and desc)
-kidneys
-esophagus
-rectum

13

pancreatic trauma- causes what?

-cause of retroperitoneal hematomas!!
-grey-turner (flank), cullen (umbilicus) signs
-CT