the bile ducts PENNY
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