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Gallbladder Review

Terms in this set (23)

junctional fold
most common variant of the GB
white, bilirubin
Lab values of biliary tract diseases
______ blood cell count - in cases of infection, cholecystitis, cholangitis
______ - incases in cases where the biliary system becomes obstructed
abnormal LFTS
Serum alkaline phosphatase - increases in cases of posthepatic jaundice
Prothrombrin Time - longer in pts with acute cholecystitis, carcinoma of the GB and prolonged CBD obstruction
painless jaundice, enlarged
Courvoisier GB or sign states that in a patient with _____ _____ and an _______ gallbladder (or right upper quadrant mass), the cause is unlikely to be gallstones and therefore presumes the cause to be an obstructing pancreatic or biliary neoplasm until proven otherwise.
intrahepatic, chronic
Causes of small GB
1) Pt has eaten
2) _______ biliary obstruction
3) _______ cholecystitis
4) Liver disease
5) (rare) congenital hypoplasia of the GB
Cholecystitis, extrahepatic
Biliary sludge
Most common cause is stasis of bile attributable to
1)_______
2) ______ obstruction
3) hyperalimentation
Sludge is a common precursor to gallstones
adenomyomatosis
hyperplastic change in the GB wall
sickle cell anemia, cystic fibrosis
Causes of gallstones in children include
1) hymolysis
for example
- _____
- ____ _____
- malabsorption syndrome (Crohn' s disease)
- hepatitis
- congenital biliary anomalies (choledochal cyst, biliary atresia)
Mirizzi syndrome
Common hepatic duct obstruction caused by a stone in the cystic duct with a normal common bile duct.
RUQ PAIN, jaundice and fever
Acute cholecystitis
Inflammation of the GB
Pt may be present w/ acute RUQ pain may radiate to the right scapular area
Pt may present w/ focal pain over the GB (murphy's)
Wall thickening - >3 mm
halo sign suggestive subserosal edema
cystic artery along the anterior GB wall
trv diameter >5 mm
sludge
pericholecystic fluid
LABS elevated bilirubin and abnormal LFTS
empyema
pus in the gallbladder
emphysematous
______ cholecystitis
Rare occurrence caused by gas forming bacteria in the wall of the gallbladder
gangrene
caused by absence of blood supply to the gallbladder
perforation
______ of the GB caused by infection and gallstones
ascending cholangitits
caused by spreading of the inflammation of the GB
Acalculous cholecystitis
less than 5% of patients with cholecystitis will not have gallstones. The cause is a combinination of bile stasis and direct vascular changes. The etiology of this combination: trauma, pts who are NPO for a long time
chronic cholecystitis
caused by recurrent of chronic inflammatory changes of the GB. Most common cause of symphtomatic GB disease and is associated with gallstones in 90% of cases
Porcelain gallbladder
an intramural calcification of the GB wall which occurs in association with chronic cholecystitis in most cases. Has an increased incidence of GB carcinoma.
adenoma
Most common of the benign gallblaadder tumors. They are frequently located in the fundus portion of the gallbladder and <1 cm in size. Sonographically they appear as low level echo masses that do not shadow or move to the dependent portion of the gallbladder.
adenomyomatosis
a form of hyperplastic cholecystosis characterized by
- Hyperplasia of the epithelial and muscular surfaces of the gallbladder wall
- Epithelial and intramural diverticula
Sonographic appearance
Diffuse or segmental wall thickening
Intraluminal diverticula that appear echogenic with distal shadowing or comet tail artifact.
Cholesterolosis
- "strawberry GB"
- A form of hyperplastic cholecystosis
- may appear similar to adenomyomatosis w/ out the reverb artifact
Polyps
small echo-densities attached to the GB wall by a stalk
They do not shadow or move to the dependant portion of the gallbladder
pancreatic cancer
What is the most common malignant cause to obstruct the biliary tree
adenocarcinoma
solid mass filling the GB lumen, localized thickened GB with a small GB lumen
Fungating mass projecting from the GB wall into the lumen
Secondary findings
Liver mets
Regional lymphadenopathy
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