the bile ducts PENNY

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the biliary duct wall should never measure over

5mm

a patient presents with jaundice, pain and fever secondary to an impacted stone in the cystic duct. this is referred to as

Mirizzi syndrome

Mirizzi syndrome

a clinical condition when the patients presents with pain, jaundice, and fever secondary to a stone lodged in the cystic duct.

biliary stasis

a condition in which bile is stagnant and allowed to develop into sludge or stones

biliary atresia (pediatric)

a disease described as the narrowing or obliteration of all or portion of the biliary tree. poor prognosis and infants will eventually suffer from cirrhosis and portal hypertension. sono: absent biliary ducts.

bilirubin

a yellow pigment found in bile that is produced by the breakdown of red blood cells by the liver

there are several types of cholangitis

acute bacterial, AIDS, oriental and sclerosing

pneumobilia

air within the biliary tree. sono: echogenic LINEAR structures within the ducts that product ring down artifacts.

the merging point of the pancreatic duct and common bile ducts at the level of the duodenum

ampulla of Vater

a Klatskin tumor is located

at the junction of the right and left hepatic ducts

64 yo man presents with RUQ pain, weight loss, and pruritus. You visualize dilated ducts with an abrupt end. the most likely diagnosis?

cholangiocarcinoma

a klatskin tumor is a form of

cholangiocarcinoma

a 32 yhear old female patient presents to the departmwnt with fever, leukocytosis, RUQ pain. you visualize dialated bile ducts that have thickened walls and contain sludge. what is the most likely diagnosis

cholangitis

this makes the gallbladder contract

cholecystokinin

infact sonogram reveals a cystic mass in the CBD that is causing focal enlargement. this is most suggestive of:

choledocal cyst

what is not a plausible cause of CBD obstruction?

choledochal cyst

what is the most distal portion of the biliary tree?

common bile duct

Caroli disease

congenital disorder characterized by segmental dilation of the intrahepatic ducts.

the gallbladder is attached to the biliary tree by the

cystic duct

the spiral valves of heister are located within the

cystic duct

the most common level for biliary obstruction is

distal common bile duct

cholecystokinin is produced by the

duodenum

the "shotgun"

enlargement of the common duct to the sizxe of the adjacent portal vein

which segment of the biliary tree tends to dilate first with obstruction?

extrahepatic

cholangitis

inflammation of the biliary ducts. bile ducts walls thicker than 5mm. clinical: elevated bilirubin and alkaline phosphatase, leukocytosis. sono: biliary dilatation, sludge, stones and duct wall thickening.

if a gallstone, causing obstruction, is located within the distal common hepatic duct, what would become dilated?

intrahepatic ducts

which is the most proximal portion of the biliary tree?

intrahepatic radicles

chyme

partially digested food

air within the biliary tree is referred to as

pneumobilia

you visualize scattered echogenic linear structures within the liver that cause ring down artifact. the likely diagnosis?

pneumobilia

cholangiocarcinoma

primary biliary tree cancer. Klatskin tumors are the most common manifestation. clinical: elevated BILIRUBIN, ALKALINE PHOSPHATASE, PRURITUS. sono: dilated intrahepatic ducts, a solid mass may be noted.

pruritus

severe itchiness to the skin

the cystic duct contains

spiral valves of heister. they prevent the duct from collapsing.

serum bilirubin

the amount of bilirubin found in the blood

bile is produced in

the liver

ampulla of vater

the merging point of the pancreatic duct and common bile duct just before the sphincter of Oddi.

sphincter of oddi

the opening that allows bile and pancreatic juices to flow into the DUODENUM

choledocholithiasis

the presence of a gallstone within the biliary tree. clinical: elevated bilirubin, alkaline phosphatase. sono:echogenic foci

Klatskin tumor

these tumors are located at the junction of the right and left hepatic ducts and cause dilation of the intrahepatic ducts. associated with cholangiocarcinoma


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