Biliary tract diseases resident survival guide: Difference between revisions

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{{CMG}}; {{AE}} {{VR}}


==Cholelithiasis==
===Definitions===
{|class="wikitable"
! Terms!! Definitions
|-
| Cholelithiasis (gallstones)|| Cholelithiasis (gallstones) are crystallized pieces of bile including cholesterol and bilirubin in the gallbladder, which can range from microscopic to more than one inch in size and from one stone to hundreds in number.
|-
| Microlithiasis (biliary sludge)|| Microlithiasis (biliary sludge) are crystals and stones in the gallbladder that are too small to see with the naked eye.
|-
| Asymptomatic (incidential) cholelithiasis|| Asymptomatic (incidential) cholelithiasis refers to incidentally detected gallstones during routine ultrasound for other abdominal conditions or occasionally by palpation of the gallbladder at operation in patients who do not have any abdominal symptoms or have symptoms that are not thought to be due to gallstones.
|-
| Symptomatic and uncomplicated cholelithiasis|| Symptomatic and uncomplicated cholelithiasis refers to stones in the gallbladder that are associated with biliary colic in the absence of complications such as acute cholecystitis, cholangitis, or gallstone pancreatitis.
|-
| Symptomatic and complicated cholelithiasis|| Symptomatic and complicated cholelithiasis refers to stones in the gallbladder that are associated with upper abdominal pain, not typical of biliary colic in the presence of complications such as acute cholecystitis, cholangitis, or gallstone pancreatitis.
|-
|}
===Causes===
====Life Threatening Causes====
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
====Common Causes====
===Management===
{{familytree/start |summary=Cholelithiasis}}
{{familytree | | | | | | | | | | | | | A01 | | | | | | | | | | | | | | |A01=<div style="float: left; text-align: left; line-height: 150% ">'''Characterize the symptoms:''' <br> ❑ Asymptomatic <br> ❑ Symptomatic </div> }}
{{familytree | | | | | | | | | | | | | |!| | | | | | | | | | | | | | | |}}
{{familytree | | | | | | | | | |,|-|-|-|^|-|-|-|.| | | | | | | | | | | | | | | | | }}
{{familytree | | | | | | | | | B01 | | | | | | B02 | | | | | | | | | | | | | | | |B01=<div style="float: left; text-align: left; line-height: 150% ">'''Asymptomatic:'''<br> Gallstones identified during<br> ❑ Imaging evaluation of abdominal and pelvic diseases<br> ❑ Palpation of gallbladder at operation </div>|B02=<div style="float: left; text-align: left; line-height: 150% ">'''Symptomatic:'''<br> ❑ Abdominal pain<div class="mw-collapsible-content"> <div class="mw-collapsible mw-collapsed">
:❑ Right upper quadrant or epigastric or substernal pain
:❑ Sharp, intermittent and cramping pain
:❑ Pain for at least 30 minutes (but <6 hours) 
:❑ Pain radiating to right shoulder blade
:❑ Pain after food intake
:❑ Recurrent attacks ranging from hours to years</div></div>
<br>❑ Nausea & vomiting<br>❑ Diaphoresis </div>}}
{{familytree | | | | | | | | | |!| | | | | | | |!| | | | | | | | |}}
{{familytree | | | | | | | | | C01 | | | | | | |!| | | | | | | | |C01=<div style="float: left; text-align: left; line-height: 150% ">❑ Observation<br>❑ Expectant management<br>❑ Prophylactic cholecystectomy</div>}}

Latest revision as of 13:51, 24 January 2014