Term
| RFs: OCPs, preg, obesity, metabolic s/o, incr lipid, rapid wt loss, gallbladder stasis |
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Definition
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Term
MC in Asia
-RFs: chronic hemolytic s/o, biliary infxn (bact, parasites), Ileal dz/resection, CF w/ pancreatic insuff |
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Definition
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Term
| Steps to form cholesterol stone |
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Definition
1. Supersat of bile w/ cholesterol
2. Gallbladder hypomotility promotes crystal nucleation
3. accelerated nucleation
4. mucus hypersecretion promotes crystal in sonte (w/ GB stasis) |
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Term
| Mix of insoluble oxidized calcium salt of unconjugated bili, along w/ inorganic calcium salts |
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Definition
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Term
What color of stone:
-sterile, sml almost always multiple, surface is spiculated or molded may crumble
-Radioopaque (csan be seen on Xray) |
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Definition
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Term
what color of stone:
-assoc w/ infxn, lamellated & soft w/ a soap like or greasy consistency
-typically radiolucent (can't be seen on Xray) |
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Definition
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Term
| Diff btw calcous and acalculous acute cholecystitis |
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Definition
-Calculous- assoc w/ gallstones
-acalculous- not assoc w/ gallstones |
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Term
| RF for acalculous acute cholescystitis |
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Definition
-thought to be assoc w/ ischemia
RF: sepsis w/ hypotension and multi organ system failure, immunosuppresion, major trauma, DM |
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Term
| complication of acute cholecystitis |
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Definition
| Bacterial superinfxn w/ cholangitis or sepsis, gall bladder perforation, local abscess formation, biliary-enteric fistula w/ possible ileus |
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Term
-Assoc w/ gallstones
-Rokitansky-Aschoff sinuses |
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Definition
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Term
| Chronic cholecystitis Porcelin GB is assoc w/ |
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Definition
| Incr risk of gallbladder adenocarcinoma |
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Term
-Ascending cholangitis
-bugs are |
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Definition
| E coli, Klebsiella, Enterobacter, Enterococcus |
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Term
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Definition
-Echonicoccal infxn
-Chornic cholecystitis
-Chronic pancreatitis |
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Term
-present before age 10 w/ nonspecific jaundice
-Incr risk of extrahepatic cholangiocarcinoma in older pts |
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Definition
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Term
-In asia assoc w/ infxn
-MOST IMPT RF is cholelithiaisis (hint its a cancer) |
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Definition
| Carcinoma of the gallbladder |
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Term
| Infiltrative pattern: more common than exophytic. Diffuse thickening of GB wall, Firm, schirrhous, poss deep ulceration or penetration of gallbladder wall |
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Definition
| Carcinoma of the gallbladder |
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Term
| Carcinoma of the Gallbladder the exophytic pattern is most common in : |
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Definition
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Term
Carcinoma of the gallbladder:
which tumors have better px than others?
-What is the px? Good or bad |
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Definition
-Papillary tumors have better px than others
-bad- 5yr survival is 5-12% despite surgical intervention :( |
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Term
| RFs for carcinoma of extrahepatic bile ducts (aka cholangiocarcinoma) |
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Definition
RFs: choledochol cysts, exposure to Thorotrast, HCV infxn, primary sclersoing cholangitis
in Asia: major RF is hcornic infxn w/ flukes (Opithorchis sinesin) |
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Term
| Px for carcinoma of extrahepatic bile duct (aka cholangiocarcinoma) |
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Definition
Px is v poor for all cholangiocarcinomas
-esp intrahepatic (medial death is 6mnths) |
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Term
Carcinoma of bile ducts (cholangiocarcinoma)
-Which is more common intraheptaic or extrahepatic |
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Definition
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Term
Klatskin tumors usu have slower growth prominant fibrosis and infrequent distal mets
They are part of which cancer? |
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Definition
| Carcinoma of the extrahepatic bile ducts (cholangiocarcinoma) |
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Term
RFs: What is it?
-80% d/t biliary tract dz
-male= alcohol related, women=gallstones
-Metabolic s/o- HyperTGs, hyperCa
-Ischemia, trauma or inherited |
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Definition
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Term
-middle ages male (assoc w/ long term alcohol abuse)
-silent until presents w/ pancreatic insuff (wt loss, hypoalbuminemia) & DM |
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Definition
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Term
Relative sparing of islets
-gross: v firm, hard gland, calcified concretions may be visible even grossly (& on radiograph and CT) |
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Definition
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Term
| Pseudocysts can be seen in |
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Definition
| acute and chronic pancreatitis |
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Term
-nonspecific abd pain or palpable mass
-benign neoplasm, 60-70yo female
histo: well circumscribed mass w/ glycogen rich cuboidal cells surrounding small cyts which contain clear, straw colored fluid
-Px- surgical resection if curtaive :) |
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Definition
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Term
-painless, slow growing, benign
-FEMALE
Histo: body or tail of pancreas
-cysts filled w/ thick mucin, lined by columnar, mucin producing cells
-assoc dense stroma that resembles ovarain stroma
-Px: up to 1/3 contain invasive CA- req full path exam after resection |
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Definition
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Term
assoc w/ Von Hippel Lindaou dz, ADPKD
-Cyts lined by cuboidal epithelium or linning poss flattened if intraluminal press in cytrs is hi
-surrouned by thin fibrous capsul |
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Definition
| congenital cyst (pancreas) |
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Term
-localized collection of necrotic & hemmorrahgic material
-Usu solitary, peripancreatic location
-No epithelial lining
-may be seen in acute/chornic pancreatitis |
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Definition
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Term
-Strongest RF is smoking,
Other RF: chornic pancreatitis, DM
-painless jaundice,Tousseau sign
CEA and CA19-9 |
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Definition
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Term
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Definition
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Term
| Px for pancreatic carcinoma |
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Definition
Fewer than 20% resectable at dx
-Dismal 5 yr surival (<5%) :( |
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Term
-MC cause in adult is cholethiasis
-children d/t biliary atresia, CF, choledochal cyts or paucity of bile duct obs
-Pruritis, incr Alk pos, GGT
-End stage liver w/ yellow-green pigmentatio |
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Definition
| secondary biliary cirrhosis |
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Term
40-50 yo, pruritis, anti-mitochondrial Abs
-may see hyperpigmentation & inflammatory arthropathy in some pts, hepatomegaly, eyelid xanthelesmas
-incr risk of hepatocellular carcinoma
-Noncaseating granulomas may be present |
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Definition
| primary biliary cirrhosis |
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Term
-20-50 yo male, assoc w/ ulcerative coliits
-Pruritis, incr alk phos
-autoabs: ANA, anitSMA, atypical pANCA |
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Definition
| primary sclerosing cholangitis |
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Term
-beaded appearnce when imaging biliary tree d/t irreg strictures and dilations of affected bile ducts
-Onio skini fibrosis |
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Definition
| Primary sclerosing cholangitis |
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Term
Primary sclerosing choloangtis
you have in incr risk of what? |
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Definition
-cholangioCa
-chronic pancreatitis
-Hepatocellular CA |
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Term
| Feathery degeneration of hepatocytes will be seen |
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Definition
in cholestasis
(cholestasis can be seen in SBC, PBC and anything that has cholestasis) |
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