PATH 1017 - Hepatobiliary Notes With Complete Solutions
100% Verified!!
disorders of the gallbladder
- cholelithiasis (gallstones)
- acute and chronic cholecystitis
- choledocholithiasis (not tested)
- cholangitis (not tested)
cholelithiasis (gallstones)
cholesterol, calcium salts or mixed
acute and chronic cholecystitis
inflammation caused by irritation due to concentrated bile
what is cholelithiasis caused by
precipitation of cholesterol (80%) and 20 % bilirubin - black, brown pigment composed
of myucin, glycoprotein, and calcium salt.
Gallbladder sludge
-thickened gallbladder mucoprotein with tiny trapped cholesterol crystals
-precursor to formation of stones
why is cholelithiasis associated with obesity?
liver makes more cholesterol, therefore more gallstones are produced
,why is cholelithiasis associated with women?
estrogen causes fewer bile acids to be produced, which break down cholesterol (there
is a higher risk for pregnant women and those on birth control due to estrogen
decreasing bile synthesis causing more cholesterol to be excreted by liver to the bile)
symptoms of cholelithiasis
- no symptoms until obstruction of blood flow (transient)
- symptoms include jaundice, severe right upper quadrant pain, and indigestion
what is obstructed bile flow?
when the gallstones block the bile duct or cystic duct
factors contributing to the formation of gall stones
- abnormal composition of bile
- stasis of bile (anything that slows ongoing forward movement, allowing crystals and
substances to sit there and form stones)
- increased level of cholesterol
- gallbladder sludge (contracts the crystals and allows them to form)
- inflammation of gallbladder(alters abosorptive characteristics of mucosal layer
allowing increase in absorption of water and bile salts.)
what will happen to the gallstones in cholelithiasis?
either pass or go back to the gallbladder
acute cholecystitis
- inflammation caused by irritation caused by bile due to complete or partial obstruction
, of the cystic duct by stone(s)
- more concentrated bile because of blockage
-associated with presence of gallstones (85-90%)
what happens to the mucosa in acute cholecystitis?
- mucosal phospholipase is released and disrupts the mucosa, exposing mucosa to bile
salts (goes through mucosal lining)
- results in inflammation, edema, and bile stasis
what may occur/develop in acute cholecystitis?
- secondary bacterial infections (acalculous cholecystitis)
- gangrenous changes and perforation (bc of transmural infarction rather than
inflammation changes with stone)
manifestations in acute cholecystitis?
VARY IN SEVERITY
- pain (right upper quadrant pain)
- jaundice (always present)
- fever (due to inflammation)
- vomiting (75%)
- elevated blood tests WBC, total serum bilirubin, AST, ALP(indicates blocking that
doesn't allow bile to move through)
elevated blood tests in acute cholecystitis?
100% Verified!!
disorders of the gallbladder
- cholelithiasis (gallstones)
- acute and chronic cholecystitis
- choledocholithiasis (not tested)
- cholangitis (not tested)
cholelithiasis (gallstones)
cholesterol, calcium salts or mixed
acute and chronic cholecystitis
inflammation caused by irritation due to concentrated bile
what is cholelithiasis caused by
precipitation of cholesterol (80%) and 20 % bilirubin - black, brown pigment composed
of myucin, glycoprotein, and calcium salt.
Gallbladder sludge
-thickened gallbladder mucoprotein with tiny trapped cholesterol crystals
-precursor to formation of stones
why is cholelithiasis associated with obesity?
liver makes more cholesterol, therefore more gallstones are produced
,why is cholelithiasis associated with women?
estrogen causes fewer bile acids to be produced, which break down cholesterol (there
is a higher risk for pregnant women and those on birth control due to estrogen
decreasing bile synthesis causing more cholesterol to be excreted by liver to the bile)
symptoms of cholelithiasis
- no symptoms until obstruction of blood flow (transient)
- symptoms include jaundice, severe right upper quadrant pain, and indigestion
what is obstructed bile flow?
when the gallstones block the bile duct or cystic duct
factors contributing to the formation of gall stones
- abnormal composition of bile
- stasis of bile (anything that slows ongoing forward movement, allowing crystals and
substances to sit there and form stones)
- increased level of cholesterol
- gallbladder sludge (contracts the crystals and allows them to form)
- inflammation of gallbladder(alters abosorptive characteristics of mucosal layer
allowing increase in absorption of water and bile salts.)
what will happen to the gallstones in cholelithiasis?
either pass or go back to the gallbladder
acute cholecystitis
- inflammation caused by irritation caused by bile due to complete or partial obstruction
, of the cystic duct by stone(s)
- more concentrated bile because of blockage
-associated with presence of gallstones (85-90%)
what happens to the mucosa in acute cholecystitis?
- mucosal phospholipase is released and disrupts the mucosa, exposing mucosa to bile
salts (goes through mucosal lining)
- results in inflammation, edema, and bile stasis
what may occur/develop in acute cholecystitis?
- secondary bacterial infections (acalculous cholecystitis)
- gangrenous changes and perforation (bc of transmural infarction rather than
inflammation changes with stone)
manifestations in acute cholecystitis?
VARY IN SEVERITY
- pain (right upper quadrant pain)
- jaundice (always present)
- fever (due to inflammation)
- vomiting (75%)
- elevated blood tests WBC, total serum bilirubin, AST, ALP(indicates blocking that
doesn't allow bile to move through)
elevated blood tests in acute cholecystitis?
