Gallbladder disease (main): Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*[[RUQ pain]] | *[[RUQ pain]] | ||
*Additional features vary by pathology | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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*CBC | *CBC | ||
*Chemistry | *Chemistry | ||
*LFTs | *[[LFTs]] | ||
*Lipase | *Lipase | ||
*PT/PTT | *PT/PTT | ||
*[[Biliary ultrasound]] | *[[Biliary ultrasound]] | ||
==Management== | |||
*[[Analgesia]] PRN | |||
*Management varies per specific pathology | |||
==Disposition== | |||
*Dependant on pathologic process | |||
==See Also== | ==See Also== | ||
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==References== | ==References== | ||
<references/> | |||
[[Category:GI]] | [[Category:GI]] | ||
[[Category:Surgery]] | [[Category:Surgery]] | ||
Latest revision as of 22:07, 27 March 2024
Background
Gallbladder disease types
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Bile duct and pancreas anatomy. 1. Bile ducts: 2. Intrahepatic bile ducts; 3. Left and right hepatic ducts; 4. Common hepatic duct; 5. Cystic duct; 6. Common bile duct; 7. Sphincter of Oddi; 8. Major duodenal papilla; 9. Gallbladder; 10-11. Right and left lobes of liver; 12. Spleen; 13. Esophagus; 14. Stomach; 15. Pancreas: 16. Accessory pancreatic duct; 17. Pancreatic duct; 18. Small intestine; 19. Duodenum; 20. Jejunum; 21-22: Right and left kidneys.
- Symptomatic cholelithiasis (biliary colic)
- Choledocholithiasis
- Acute calculous cholecystitis
- Ascending cholangitis
- Acalculous cholecystitis
- Biliary atresia
- Cholestasis of pregnancy
Anatomy & Pathophysiology
- Gallstones are classified as cholesterol stones and pigmented stones (black and brown), and are present in approx 20% of females and 8% of males in the United States
- These stones cause the majority of all biliary tract problems, and depending on where the stone become impacted, specific problems occur.
- Bile flows out the gallbladder, down the cystic duct into the common bile duct, and ultimately into the 1st portion of the duodenum.
Clinical Features
- RUQ pain
- Additional features vary by pathology
Differential Diagnosis
RUQ Pain
- Gallbladder disease
- Pancreatitis
- Acute hepatitis
- Pancreatitis
- GERD
- Appendicitis (retrocecal)
- Pyogenic liver abscess
- Bowel obstruction
- Cirrhosis
- Budd-Chiari syndrome
- GU
- Other
- Hepatomegaly due to CHF
- Peptic ulcer disease with or without perforation
- Pneumonia
- Herpes zoster
- Myocardial ischemia
- Pulmonary embolism
- Abdominal aortic aneurysm
Evaluation
- CBC
- Chemistry
- LFTs
- Lipase
- PT/PTT
- Biliary ultrasound
Management
- Analgesia PRN
- Management varies per specific pathology
Disposition
- Dependant on pathologic process