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]

• Pain

  […] in ~2%/y; once sx, rate of complications ~2%/y • Biliary pain (“colic”) = episodic RUQ or epigastric abd pain that begins abruptly, is continuous, resolves slowly and lasts for 30 min–3 h; ± radiation to scapula; nausea • May be precipitated by fatty [doctorlib.info]

  The pain may radiate to the back, right flank or tip of the right scapula. It is often described as an intermittent or “colicky” pain that is burning, pressure-like, or heavy in nature. [cdemcurriculum.com]

  Gallstone attacks can produce chest pain that may feel like a heart attack. If a pain is new and different than other pains the symptoms should be discussed with a physician. [patients.gi.org]

  A 48-year-old African American woman presents to theemergency department with anorexia, nausea, vomiting,and abdominal pain over the last week. The pain wasinitially in the midepigastric area but has shifted to the rightupper quadrant. [proprofs.com]

• Inflammation

  Inflammation of the pancreas is best demonstrated by an abdominal CAT scan, which can also determine the severity of the pancreatic inflammation. [patients.gi.org]

  […] kolangiitti cholangitis noun en Inflammation of the bile duct. [fi.glosbe.com]

  Cholecystitis - Inflammation of the gallbladder, may be acute or chronic - Almost always seen in association with gallstones, otherwise it is designated as acalculous cholecystitis Acute cholecystitis - Acute calculous cholecystitis o 90% result from [medschool.lsuhsc.edu]

  The initial inflammation is caused by chemical irritation, and bacterial infection probably is a secondary event. [emedicine.medscape.com]

• Fever

  High fever is rare. How does cholangitis present? Cholangitis is a gastrointestinal emergency. The patient presents with a triad of high spiking fevers with rigors, jaundice, and right upper quadrant pain. [cram.com]

  The persistence of symptoms longer than 6 hours or complaints of fever or jaundice suggest more serious disease. [cdemcurriculum.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]

  Charcot triad (ie, fever, right upper quadrant pain, jaundice) occurs in only 20%-70% of cases. [emedicine.medscape.com]

  Persistent pain or fevers suggest severe pancreatitis and ongoing inflammation. Intravenous delivery of nutrients should be started if oral intake cannot be resumed within approximately 5-7 days. [patients.gi.org]

• Sepsis

  Cholestasis of sepsis. Intrahepatic disease: Acute Liver: acute disease and chronic liver disease Liver: chronic disease - overview. Cholangitis and cholangiohepatitis Liver: cholangiohepatitis. [vetstream.com]

  > ischemia. when edema of GB wall in acalculous cholecystitis compromises blood flow, accumulation of microcrystals, vixcous bile and mucus -- cause cystic duct obstruction. risk factors for acalculous cholecystitis 1. sepsis with hypotension and organ [quizlet.com]

  Signs may range from localised abdominal tenderness through to generalised peritonitis with overwhelming sepsis. [abdominalkey.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]

  In the presence of sepsis, aggressive fluid resuscitation and blood pressure support may be necessary. Prompt surgical consultation is imperative. [cdemcurriculum.com]

• Weight Loss

  Patients usually present with jaundice, a vague upper or right upper quadrant abdominal pain associated with anorexia, weight loss, and pruritus. Ampullary cancer Ampullary cancer accounts for 8% of biliary tract cancers. [emedicine.medscape.com]

  Female gender, older age, obesity, high blood cholesterol levels, treatment with estrogen containing medications, rapid weight loss, diabetes and pregnancy are all risk factors for developing cholesterol gallstones. [patients.gi.org]

  Signs and Symptoms Patients typically present with jaundice and pruritus and more generalized symptoms, such as weight loss, anorexia, and fatigue. [clevelandclinicmeded.com]

  Upper abdominal pain, often radiating to the back, and weight loss are the most common symptoms of pancreatic cancer. Obstructive jaundice is a frequent symptom when the head of the pancreas is involved. [britannica.com]

  Consider the Patient’s Risk Factors Female gender Age > 40 years Family history Obesity Multiparity Rapid weight loss Sickle Cell or other hemolytic disorders (pigmented stones) Diabetes (increased risk of cholecystitis) Look at the Patient A well-appearing [cdemcurriculum.com]

• 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]

• Epigastric Pain

  […] in ~2%/y; once sx, rate of complications ~2%/y • Biliary pain (“colic”) = episodic RUQ or epigastric abd pain that begins abruptly, is continuous, resolves slowly and lasts for 30 min–3 h; ± radiation to scapula; nausea • May be precipitated by fatty [doctorlib.info]

  pain, persist more than 6 hours o Murphy’s sign: patient asked to breath out, examiner’s hand presses on the right hypochondrial area, patient is asked to breath in; if gallbladder is inflamed, inspiration is inhibited by pain o Nausea, vomiting o Mild [medschool.lsuhsc.edu]

  /epigastric pain - mild fever, anorexia, tachycardia, sweating, nausea, vomiting (most pts free of jaundice) - hyperbilirubinemia -- indicates obstruction of common bile duct. clinical sx of acute acalculous cholecsytitis more insidious onset -- obscured [quizlet.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]

  Gallstone pancreatitis manifests with typical features of pancreatitis, including epigastric pain, nausea, and vomiting. Diagnosis Several diagnostic tools can be used when evaluating patients suspected of having choledocholithiasis. [clevelandclinicmeded.com]

• Constipation

  Symptoms of digestive diseases—gastrointestinal (GI) conditions—can be very uncomfortable, such as diarrhea, bloating, constipation, or other difficulties related to digesting food. [wehealny.org]

  Neoplasms of the biliary tract Carcinoma of the biliary system manifests with clinical symptoms of weight loss (77%), nausea (60%), anorexia (56%), abdominal pain (56%), fatigue (63%), pruritus (51%), fever (21%), malaise (19%), diarrhea (19%), constipation [emedicine.medscape.com]

• Heart Disease

  Therefore, it would be important to verify that the patient does not have stones within the bile ducts, cancer of the pancreas or bile ducts, peptic ulcer disease or heart disease (poor blood flow to the heart, called “ischemia” or “angina” may mimic [patients.gi.org]

  […] and von Hippel-Lindau disease 2. [medschool.lsuhsc.edu]

• Jaundice

  Extrahepatic bile duct obstruction is a well-recognized syndrome because of its association with pancreatitis and obvious jaundice. [ncbi.nlm.nih.gov]

  Unconjugated jaundice Unconjugated, or hemolytic, jaundice is characterized by the absence of bile pigments in the urine and by normal stool colour. [britannica.com]

  The patient presents with a triad of high spiking fevers with rigors, jaundice, and right upper quadrant pain. Note: If tumor is obstructing the common bile duct, painless jaundice may develop gradually over weeks prior to onset of infection. [cram.com]

  Charcot triad (ie, fever, right upper quadrant pain, jaundice) occurs in only 20%-70% of cases. [emedicine.medscape.com]

  The principle objective in treating patients with malignant biliary diseases, presumed to be unresectable, is to provide palliation of the jaundice. [gut.bmj.com]

• 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]

• Ulcer

  ulcerated, ulcerating, ulceration, ulcerative 707.9 bile duct 576.8 gall duct 576.8 [icd9data.com]

  Risk factors include age, race, gender, a diet high in fat, smoking, diabetes, family history, exposure to pesticides, certain dyes and chemicals, ulcers, and chronic pancreatitis. [britannica.com]

  PSC is strongly associated with ulcerative colitis in up to 70% of patients, but it can also be associated with Crohn's disease of the large intestine. [radiologyassistant.nl]

  The cause is unknown but is associated with autoimmune inflammatory diseases, such as chronic ulcerative colitis and Crohn colitis (less commonly), and rare conditions, such as Riedel thyroiditis and retroperitoneal fibrosis. [emedicine.medscape.com]

  Therefore, it would be important to verify that the patient does not have stones within the bile ducts, cancer of the pancreas or bile ducts, peptic ulcer disease or heart disease (poor blood flow to the heart, called “ischemia” or “angina” may mimic [patients.gi.org]

• 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]

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]

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]

• 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]

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 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]

[…] 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]

Following recovery from an acute attack, the prevention of further attacks should be the primary goal. [britannica.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]

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]