Flashcards in Path Biliary Deck (23):
endodermal, ventral medial outgrowth of the foregut
Regulatory hormones of the gallbladder
Cholecystokinin and somatostatin
presence of calculi (gallstones) in the gallbladder or biliary tree
Occur more frequently in women. Can be caused by excess cholesterol synthesis or decreased production/recycling of bile salts (lecithin). Predisposing factors: estrogen, advanced age, obesity, family hx, high cholesterol diet, diabetes, primary biliary cirrhosis
measure < 1 cm, composed of calcium bilirubinate, calcium salts, mucin. Occur in elderly, malnourished, sickle cell, cirrhosis, and thalassemia. Due to high concentrations of UNCONJUGATED bilirubin in bile = insoluble/precipitates.
Mixed (brown pigment) stones
Mix of cholesterol and bilirubin. Found in intra and extra hepatic ducts rather than the gallbladder
Inflammation of the gallbladder - almost always associated with gallstones. Acute cholecystitis - fibrinous exudates. Detergent bile salts damage mucosa. bacterial infection with clostridia or coliform bacteria = gangrenous cholecystitis which can lead to perforation. Chronic cholecystitis = thickened wall due to fibrosis and Rokitansky-Aschoff sinuses.
Histological change seen in the wall of the gallbladder indicative of CHRONIC CHOLECYSTITIS. Penetration of the mucosa into the muscular layer of the gallbladder
accumulation of cholesterol filled macrophages in the lamina propria of the gallbladder. Common finding at autopsy. Mucosa appears speckled with yellow flecks. When extreme, condition is called a "strawberry gallbladder". No associated with hypercholesterolemia
Benign tumors of the gallbladder
Papillomas and mucous gland adenomas. If smooth muscle proliferates = adenomyoma.
Malignant tumors of the gallbladder
Adenocarcinoma of the gallbladder is associated with?
Chronic cholecystitis and cholelithiasis
Presence of calculi within the biliary tree
Choledocholithiasis can lead to?
pancreatitis, cholangitis, hepatic abscess, secondary biliary cirrhosis, acute calculous cholecystitis
Inflammation and infection of the hepatic ducts and common bile duct. Usually secondary to partial or complete of a septic biliary tree by calculi
Signs and symptoms of ascending cholangitis:
mild epigastric to severe RUQ pain, N/V, peritoneal irritation, RIGHT SHOULDER/SCAPULAR PAIN, palpable gallbladder. Jaundice may be intermittent or mild
Most common etiologic agents of ascending cholangitis?
E. coli, Enterobacter spp, Klebsiella spp., Proteus spp., enterococci, non-hemolytic streptococci, and Bacteroides or clostridium
Obliteration of the lumen of part or all of the hepatic biliary tree within the first 3 months of life. Initially necrosis and inflammation of the ductal epithelium. Eventually leads to fibrosis with obliteration of the lumen and resolution of inflammation. Untreated patients progress to cirrhosis
Treatment of biliary atresia?
"Kasia procedure" or portoenterostomy, but most require liver tx
uncommon dilations of the common bile duct. Usually occur in patient <10 years of age. Symptoms: jaundice and recurrent biliary colic.
angiocarcinoma arising at the junction of the left and right hepatic ducts in the hepatic hilum
Predisposing genetics for pancreatic adenocarcinoma
KRAS, CDKN2A, p53.