pathologies of the biliary tree

cholecystolithiasis vs choledocholithiasis?

cholecystolithiasis = in GB

choledocholithiasis = in duct

5f’s of who is most likely to develop gallstones?

• female

• fat

• fair

• over 40

• fertile

• family hx (in younger pts)

what is biliary colic, symptoms? pain radiates to where

when pt experiences pain in the RUQ/epigastric upon consumption of fatty foods, nausea, bloating & heartburn possible, pain may radiate to rt shoulder

sonographic appearance of cholelithiasis ?

posterior acoustic shadowing, stone movement (as pt moves - rolling stone sign), twinkle artifact

what makes acoustic shadowing more pronounced?

• larger stones

• increased frequency

• narrow sector

• linear probes

• appropriate depth

• spatial compounding off, harmonics on

Acute cholecystitis vs biliary colic?

acute cholecystitis while similar to biliary colic, lasts much longer >6 hrs (still includes fever, nausea & vomitting)

acute cholecystitis treatment?

cholecystectomy

acalculus cholecystitis (5-10%) causes and is secondary to?

caused by biliary stasis or GB ischemia, occurs secondary to major trauma/burns, post op, cardiac arrest, diabetes, malignancy

treatment of acalculus cholecystitis treatment?

cholecystectomy → if unable to = percutaneous/endoscopic drainage