Flashcards in Pathophysiology of the Gall Bladder and Biliary Tree Deck (20):
What are the two functions of the gallbladder?
- Store bile made by the liver
- Contract to deliver bile to the duodenum after a fatty meal
Gallstones almost always develop in the ____________.
What are gallstones most commonly composed of?
There are also brown stones, which indicate infection.
Describe the differences between the consistencies of cholesterol gallstones and pigment stones.
Cholesterol: like toothpaste
What are the five Fs of gallstone risk factors?
Fertile (estrogen use)
An overweight, Hispanic female presents to your office with complaints of intermittent pain – particularly after fatty meals – that lasts for about five hours. What is the cause?
Movement of gallstones through the cystic duct and common hepatic duct
How would you treat biliary colic?
Remove the gallbladder
What causes cholecystitis?
There can be calculous and acalculous causes.
Calculous: duct is blocked by stone, gallbladder gets infected
Acalculous: usually ischemia (from sepsis, surgery, trauma, vasculitis, or hypotension)
What distinguishes choledocholithiasis from calculous cholecystitis?
Choledocholithiasis is a stone in the common bile duct – meaning it blocks the liver, too. Patients will have jaundice.
Bacterial infection of the bile duct is called ____________.
ascending cholangitis (almost always due to choledocholithiasis)
A patient comes in with RUQ pain, fever, jaundice – (Charcot's triad) – hypotension, and altered mental status – (Reynold's pentad). What procedure will they likely need?
Urgent endoscopic retrograde cholangiopancreatography
What transaminase pattern will be found in someone with biliary stricture?
ALTs greater than ASTs
Cholangiocarcinoma is ___________.
adenocarcinoma of the bile duct
Why do you need to regularly monitor patients with primary sclerosing cholangitis?
Because PSC increases risk of developing cholangiocarcinoma
Pigment stones are primarily composed of ___________.
Which kind of stones develop in the bile duct?
What is biliary colic?
Pain resulting from irritation of the bile duct, usually due to passage of stones
What is Mirizzi's syndrome?
An occlusion of the cystic duct that leads to regional edema that causes blockage of the hepatic duct, as well
How are biliary strictures treated?
ERGP with dilation
Biopsy for suspected malignancy