Gallbladder Diseases

Cholelithiasis

usually cholesterol stones caused by biliary fluid filled with cholesterol because of overproduction in the liver

cholesterol and pigment stones

types of gallstones

cyhrosis, hemoylsis, and infections

causes of pigment stones in the gallbladder

Female, Forty +, Fat (fast weight changes), Fertile

the four F risk factors for gallstones

signs of gall stones

asymptomatic, feeling full, biliary colic (dull RUQ pain, gets worse after fatty meals, and lasts a few hours)

US

method of diagnosis of gallstones

8-12 hours

how long before a diagnostic US for gallstones does the patient need to fast?

treatment of gallstones

low fat diet (no eggs, cream, fat meat, fried food, cheese, and alcohol), elective choleycystectomy if the situation is severe, Usodeoxycholic acid

Usodeoxycholic acid

medication for gallstones that helps break down small cholesterol stones

acute cholecystitis

inflammation of the gallbladder caused by a stone that blocks the gallbladder. Bile builds up causing edema. Pressure on the blood vessels in the gallbladder causes necrosis, perforation, and infection

acalculous choleycystitis

choleycycstitis not caused by stones. It is usually caused by large surgery, trauma, burns, torsions, or many IVs

signs of choleycystitis

constant RUQ pain that radiates to the chest, right shoulder, and back; nausea and vomiting; Murphy’s sign

Murphy’s sign

the patient breaths in while the doctor is pressing on the RUQ. In choleycystitis the patient will not be able to finish the breath because the gallbladder will move downwards

complications of choleycystitis

necrosis, peritonitis, abscess, and fistula

US

method of diagnosis of choleycystitis

fasting, fluids, antibiotics, and opiates

first stage of treatment of choleycystitis

laproscopic cholecystectomy

second stage of treatment of choleycystitis

post op choleycystectomy instructions

low folwer position, shower 1-2 days after surgery, driving 3-4 days after surgery, no heavy lifting for 1 week, check the wound daily and wash with soap and water, low fat diet for 4-6 weeks

Choledocholithiasis

stones in the common bile duct

signs of choledocholithiasis

asymptomatic, feeling full, abdominal pain, biliary colic signs

diagnosis of choledocholithiasis

high direct bilirubin, high ALKP and GGT,\

MRCP, ERCP, and EUS

treatment of choledocholithiasis

ERCP, T tube drain, elective cholecystectomy

T tube drain

open surgery in to the CBD to remove the stones and put in a T tube that drains out the bile

ascending cholangitis

inflammation of the biliary tract usually due to a stone blocking the common bile duct

fever, jaundice, RUQ pain

Charaot’s triad. Signs of ascending cholangitis

treatment of ascending cholangitis

dast, fluids, antibiotics, ERCP to remove the stones, T tube drain, and elective choleycystectomy