gallbladder pathology/operations pt 3

Acalculus cholecystitis

acute inflammation of gallbladder with the absence of cholelithiasis

what is the cause of acalculus cholecystitis?

decrease blood flow through the cystic artery or compression of the cystic duct by mass

Acalculus cholecystitis clinically comes with a

positive Murphy sign

torsion of the gallbladder _____ Condition more often found in

rare, older women

torsion is associated with a mobile gallbladder with a

Long suspensory Mesentery

if gallbladder becomes twisted more than 180° what is the risk and what is the solution?

Gangrene, surgical intervention

what is the most common form of gallbladder inflammation

Chronic cholecystitis

chronic cholecystitis clinical symptoms

passing RUQ Pain, not as bad as acute cholecystitis

most common disease of gallbladder

Cholelithiasis

cholelithiasis

Single large gallstones or multiple tiny stones

why are tiny stones the most dangerous?

They enter bile ducts, and obstruct outflow of bile

Colelithiasis patients often fall under the five F’s

fat, female, forty, fertile, fair

porcelain gallbladder

Rare occurrence, calcium incrustacean of gallbladder wall

porcelain gallbladder is associated with ____ For most, making it A form of ____

Gallstones, Chronic cholecystitis

porcelain gallbladder causes ____ Patient to develop cancer on gallbladder wall

25%

Hyperplastic Cholecystitis is represented by a variety of changes in gallbladder

Hyperconcentration, hyperexcitability, hyperexcretion

types of hyperplastic cholecystitis of the gallbladder

cholesterolosis adenomyomatosis

why is cholesterolosis often referred to strawberry gallbladder

The mucosa resembles surface of strawberry

cholesterolosis is associated with

cholesterol stones in 50 to 70% of patients

cholesterolosis

cholesterol is deposited within lamina propria of gallbladder

adenomyomatosis

Hyperplastic change in gallbladder wall

Papillomas may occur

• singly or in groups

• Scattered around large part of mucosal surface of gallbladder

multiple patient positions and compressions show the lesion to be

immobile in the gallbladder

dilated biliary ducts:

duct diameter of____ is borderline

And duct diameter of ____ Needs further attention

5mm, 6mm

patients may have normal size ducts and still have

Distal obstruction

generally, a duct greater than ___ is Borderline

and duct greater than ____ is dilated

6 mm and 10 mm

most common cause of biliary obstruction

tumor or thrombus within ductal system

three primary areas for biliary obstruction

• intrapancreatic

• Suprapancreatic

• Porta hepatic

intrapancreatic obstruction

blockage in the intrapancreatic segment of the common bile duct or pancreatic duct

what main conditions cause intrapancreatic obstruction

pancreatic carcinoma, choledocholithiasis, chronic pancreatitis with strict formation