Bilarysurg
Classification:
GAIIStOMeS
Risk Factors: CHOLESTEROL vs. PIGMENT
Cholesterol: -80% cholesterol composition. 4 F's:
Yellow, hard. Female
·
Fourty
Mixed:25-80% cholesterol composition. Fat
mostcommon gallstone type. Fertile
·
Pigment:25% cholesterol composition.
Black, Crumbly.
·
Radio-opaque.
·
·
Associated with haemolytic anaemia.
Presentations:
Biliary Colic:
·
gallstone impaction at neck of gallbladder.
BILE TREE
elicits colicky pain when eating fatty foods,
-
as gallbladder contracts around stones.
-no fever, but can progress into cholecystitis.
·Cholecystitis:gallstones occlude cystic duct,
inflammation.
causing gallbladder
Constant RUD pain.
-
Fever, due to infection. Symptoms:
secondary
-
-
No jaundice as bile can still
travel from liver through CBD. Colicky pain:sharp that comes and goes,
RUQ pain
-Murphy's sign tive. and is exacerbated
by eating fatty foods. Radiates back.
Complications:gallbladder Post-Hepatic Jaundice:occurs only in Cholangitis,
·
empyema, ischaemia, perforation. CBD gallstone occludes bile flow completely,
where
and billirubin. accumilates.
Ascending Cholangitis:
·
gallstones occlude CBD, Steatorrhoea:pale, difficult to flush stool,
causing CBD inflammation. due to fat indigestion and lack of Stercobilin.
can progress to
septic shock. Accompanied by Marine.
· ·
Can cause Pancreatitis.
·
Dark Urine:obstruction accumilates billirubin, and is
-Charcot's triad ofsymptoms: instead of stool
excreted
through urine as Urobilinogen.
1. RUQ pain 2. Fever 3. Jaundice ·
Steatorrhoea+ Dark Urine Obstructive Jaundice.
=
-Murphy's sign-tive
Murphy's Signttire:pain RUQpalpation on inspiration.
on
Reynold's Pentad
Biliary sepsis, tive in
cholecystitis, five in Cholangitis.
- ·
progression ofascending cholangitis
·
Charcot's triad + shock/confusion
Classification:
GAIIStOMeS
Risk Factors: CHOLESTEROL vs. PIGMENT
Cholesterol: -80% cholesterol composition. 4 F's:
Yellow, hard. Female
·
Fourty
Mixed:25-80% cholesterol composition. Fat
mostcommon gallstone type. Fertile
·
Pigment:25% cholesterol composition.
Black, Crumbly.
·
Radio-opaque.
·
·
Associated with haemolytic anaemia.
Presentations:
Biliary Colic:
·
gallstone impaction at neck of gallbladder.
BILE TREE
elicits colicky pain when eating fatty foods,
-
as gallbladder contracts around stones.
-no fever, but can progress into cholecystitis.
·Cholecystitis:gallstones occlude cystic duct,
inflammation.
causing gallbladder
Constant RUD pain.
-
Fever, due to infection. Symptoms:
secondary
-
-
No jaundice as bile can still
travel from liver through CBD. Colicky pain:sharp that comes and goes,
RUQ pain
-Murphy's sign tive. and is exacerbated
by eating fatty foods. Radiates back.
Complications:gallbladder Post-Hepatic Jaundice:occurs only in Cholangitis,
·
empyema, ischaemia, perforation. CBD gallstone occludes bile flow completely,
where
and billirubin. accumilates.
Ascending Cholangitis:
·
gallstones occlude CBD, Steatorrhoea:pale, difficult to flush stool,
causing CBD inflammation. due to fat indigestion and lack of Stercobilin.
can progress to
septic shock. Accompanied by Marine.
· ·
Can cause Pancreatitis.
·
Dark Urine:obstruction accumilates billirubin, and is
-Charcot's triad ofsymptoms: instead of stool
excreted
through urine as Urobilinogen.
1. RUQ pain 2. Fever 3. Jaundice ·
Steatorrhoea+ Dark Urine Obstructive Jaundice.
=
-Murphy's sign-tive
Murphy's Signttire:pain RUQpalpation on inspiration.
on
Reynold's Pentad
Biliary sepsis, tive in
cholecystitis, five in Cholangitis.
- ·
progression ofascending cholangitis
·
Charcot's triad + shock/confusion
