Presentation
In the general population, 5% of patients presenting with cholecystitis have co-existing bile duct stones. [gut.bmj.com]
Ligation of the bile duct will present early with jaundice; however, later presentation may occur as a result of stricture formation from a partial injury, localised inflammation or ischaemic insult. [abdominalkey.com]
Presentation is in childhood or young adulthood. The simple type presents with RUQ pain and recurrent attacks of cholangitis with fever and jaundice. [radiopaedia.org]
It most commonly presents with painless jaundice or acute pancreatitis. Biliary tract cysts Cystic dilatation of the biliary tree is an uncommon abnormality. [emedicine.medscape.com]
E. coli, ascaris lumbricoides, liver fluke O. sinensis. pale yellow round to ovoid and have finely granular hard external surface. radiolucent. if sufficient calcium carbonate is present they will be opaque. - glistening radiating crystalline palisade [quizlet.com]
Gastrointestinal
- Abdominal Pain
Blockage of the bile ducts may cause symptoms such as abdominal pain, nausea and vomiting. [patients.gi.org]
About half of the patients present with some combination of jaundice, abdominal pain, and an abdominal mass. The presence of these cysts is often associated with an anomalous union of the pancreatic and biliary ductal system. [emedicine.medscape.com]
Symptomatic gallstones typically manifest with right upper quadrant abdominal pain, often accompanied by nausea and vomiting. [clevelandclinicmeded.com]
CT As CT is often the initial imaging study of choice in the evaluation of undifferentiated abdominal pain, it also plays an important role in the diagnosis of biliary disease. [cdemcurriculum.com]
- Vomiting
Blockage of the bile ducts may cause symptoms such as abdominal pain, nausea and vomiting. [patients.gi.org]
A 57-year-old man presents to the emergency departmentwith a 3-day history of nausea, vomiting, right upperquadrant pain, and fevers. [proprofs.com]
Pts (postop major surgery, TPN, sepsis, trauma, burns, opiates, immunosuppression, infxn [eg, CMV, Crypto, Campylobacter, typhoid fever]) Clinical manifestations • History: RUQ/epigastric pain ± radiation to R shoulder/back, nausea, vomiting, fever • [doctorlib.info]
Classic Presentation History The classic presentation of biliary colic (episodic pain due to gallstone obstruction of the neck of the gallbladder) is right upper quadrant (RUQ) or epigastric pain associated with nausea and vomiting. [cdemcurriculum.com]
Symptomatic gallstones typically manifest with right upper quadrant abdominal pain, often accompanied by nausea and vomiting. [clevelandclinicmeded.com]
- Nausea
Blockage of the bile ducts may cause symptoms such as abdominal pain, nausea and vomiting. [patients.gi.org]
A 57-year-old man presents to the emergency departmentwith a 3-day history of nausea, vomiting, right upperquadrant pain, and fevers. [proprofs.com]
Pts (postop major surgery, TPN, sepsis, trauma, burns, opiates, immunosuppression, infxn [eg, CMV, Crypto, Campylobacter, typhoid fever]) Clinical manifestations • History: RUQ/epigastric pain ± radiation to R shoulder/back, nausea, vomiting, fever • [doctorlib.info]
Nausea and vomiting are common associated symptoms, and most patients are afebrile early in the course of the disease. [emedicine.medscape.com]
Classic Presentation History The classic presentation of biliary colic (episodic pain due to gallstone obstruction of the neck of the gallbladder) is right upper quadrant (RUQ) or epigastric pain associated with nausea and vomiting. [cdemcurriculum.com]
Liver, Gall & Pancreas
- Biliary Colic
[…] the ingestion of fatty meals is classic for biliary colic. [cdemcurriculum.com]
colic. - predipose to stone formation, stricture, stenosis, pancreastitis. increased bile duct carcinoma in adults. [quizlet.com]
Some patients experience biliary colic, an intermittent and often severe pain in the epigastrium or right upper quadrant, and at times between the scapula because of temporary obstruction of the cystic duct with a gallstone. [clevelandclinicmeded.com]
colic and/or jaundice o Pancreatitis (when located at the distal end of the common bile duct) - Predispose to: o Calculus formation (choledocholithiasis) o Inflammation, stenosis o Pancreatitis o Cholangiocarcinoma - Treatment: excision with biliary-enteric [medschool.lsuhsc.edu]
Urogenital
- Dark Urine
Signs & Symptoms The symptoms of biliary atresia usually appear by the age of two to six weeks and include a yellowish coloration of the skin and whites of the eyes (jaundice), abnormally pale stools, and dark urine. [rarediseases.org]
The clinical features of biliary obstruction include pale stools, dark urine and itch, and are usually diagnostic. If jaundice is episodic or associated with pain, rigors and pyrexia, then obstruction is highly likely. [surgwiki.com]
Treatment
It has been recommended as first line in diagnosis and treatment [19], [36], [42], [43]. Endoscopic extraction of biliary tree parasites will relieve the obstruction and decompress the dilated biliary tree and help in treatment of cholangitis. [saudijgastro.com]
Whereas less severe cases with appropriate treatment have very good prognosis, severe cases with delayed treatment may result in grave complications such as sepsis or kidney failure Addressing issues of biliary tract obstruction in a timely manner may [dovemed.com]
Recently, the liver tumor treatment program expanded with the addition of radiofrequency (thermal) ablation which broadens the range of treatment for liver tumors. [my.clevelandclinic.org]
Once the diagnosis has been determined, our doctors base your treatment plan on years of research and experience with other patients. [hopkinsmedicine.org]
Treatment of acute hyperkalaemia in adults [PDF] This guideline has been developed to improve the treatment of acute hyperkalaemia and reduce the risk of complications associated with hyperkalaemia and its treatment. This guideline is a... [evidence.nhs.uk]
Prognosis
In severe cases of Cholangitis, endoscopic decompression may be required to drain the pus from the biliary tract The prognosis of Cholangitis depends upon the provision of timely treatment. [dovemed.com]
Treatment and prognosis Prognosis is generally poor. If disease is localized, segmentectomy or lobectomy may be offered. In diffuse disease management if generally with conservative measures; liver transplantation may be an option 1. [radiopaedia.org]
Prognosis is bleak. Perhaps some hope may be provided by hepatic transplantation. Keywords Bile Duct Biliary Tract Como Biliary Tree Ductal System These keywords were added by machine and not by the authors. [link.springer.com]
Prognosis : depends on cause - fair to guarded. Pathogenesis Etiology Extrahepatic disease: Severe red cell destruction must be considered in the jaundiced patient. Cholelithiasis. Neoplasia obstructing the bile duct: Within the gall bladder. [vetstream.com]
A fibrolamellar type is seen mainly in young women and has a much better prognosis. [surgwiki.com]
Etiology
• BD obstruction → infection proximal to the obstruction • Etiologies: BD stone (~85%) Malignant (biliary, pancreatic) or benign stricture Infection w/ fluke ( Clonorchis sinensis, Opisthorchis viverrini ) Clinical manifestations • Charcot’s triad: RUQ [doctorlib.info]
Pathogenesis Etiology Extrahepatic disease: Severe red cell destruction must be considered in the jaundiced patient. Cholelithiasis. Neoplasia obstructing the bile duct: Within the gall bladder. Within the biliary tree. At the duodenal papilla. [vetstream.com]
Biliary atresia splenic malformation syndrome: an etiologic and prognostic subgroup. Surgery. 1993;113:662-8. Carmi R, et al. [rarediseases.org]
The etiology is unknown, although some of these patients have biliary parasites. The disease is characterized by the presence of intrahepatic pigmented stones and recurrent infection. [radiologyassistant.nl]
The etiology is thought to have an ischemic basis, and a gangrenous gallbladder may result. This condition has an increased rate of complications and mortality. [emedicine.medscape.com]
Epidemiology
Pocket Medicine GASTROENTEROLOGY BILIARY TRACT DISEASE CHOLELITHIASIS (GALLSTONES) Epidemiology & pathogenesis ( J Hep 2008;48:S124) • >10% adults in the U.S. have gallstones; a/w ↑ overall mortality ( Gastro 2011;140:508) • Bile = bile salts, phospholipids [doctorlib.info]
[…] of several pediatric liver centers to collect and maintain a database of clinical information as well as serum and tissue samples from children with biliary atresia and other causes of neonatal cholestasis in order to encourage and perform clinical, epidemiological [rarediseases.org]
Human visceral leishmaniasis in Alpes-Martinmes, France: Epidemiological characteristics for the period 1985-1992. Trans. R Soc Trop Med Hyg 1994;88:33-4. 46. Grauer L, Padilla VM, Bouza L, Barkin JS. [saudijgastro.com]
Epidemiologic studies have shown variations in the prevalence of gallstones in different ethnic populations, with particularly high rates in Native Americans. [clevelandclinicmeded.com]
Pathophysiology
Pathophysiology Jaundice represents an accumulation of bilirubin within the blood and subsequently deposition within various body tissues - mucous membranes and skin are most obviously involved. [vetstream.com]
Pathophysiology and Natural History Most gallstones are composed primarily of cholesterol, with smaller amounts of mucus, calcium bilirubinate, and protein. [clevelandclinicmeded.com]
Prevention
[…] tract obstruction in a timely manner may help an individual from developing Cholangitis Please find comprehensive information on Cholangitis regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention [dovemed.com]
Thoracentesis with ultrasound may prevent hemothorax. PMC Free PDF PMC Free Full Text FREE Publisher Full Text IgG4 Sclerosing Cholangitis - an Inflammation Imitating Tumour of the Pancreas and Biliary Tract. [unboundmedicine.com]
Synchronous malignancy was found in 36 patients (20%), with only one of the remaining 144 patients developing malignancy during follow-up. 11 Management Surgical resection is required to prevent recurrent episodes of sepsis and pain, to prevent the risk [abdominalkey.com]
Following recovery from an acute attack, the prevention of further attacks should be the primary goal. [britannica.com]
In cases of infected pancreatic tissue, or a condition called pancreatic necrosis (dead tissue) occurs, antibiotics may be used to control or prevent infection. [patients.gi.org]