The sphincter of oddi is a complex arrangement of smooth muscles around the CBD, pancreatic duct and the ampulla of Vater. What is its fuction?
- Regulates flow of Bile and pancreatic juices
- Inhibits Bile into pancreatic duct
- Prevents reflux of intestinal contents into ducts
Blood supply to the Biliary system is delivered by the ___ artery and is drained through the ___ vein.
Hepatic artery and cystic vein
What hormone when released makes the gallbladder contract to release bile?
cholecystokinin-pancreozymin (CCK-PZ)
Bile is an alkaline made up of 97% water, bile salts, fatty acids, lipids, cholesterol, electrolyte, bilirubin and other substances secreted from which organ?
liver
What are some functions of bile?
- Combines undigested fats
- Absorption of fat-soluble vitamins
- Activation of intestinal and pancreatic enzymes
- Neutralize gastric acid in duodenum
What is cholelithiasis?
Presence of stones in the gallbladder
Chole = Bile duct or gall lithiasis = formation of stones
Name two types of gallstones.
- Cholesterol stones (yellow-green in colour, made primarily of hardened cholesterol)
- Pigment stones (black or brown)
What is the term used to refer to pain when a gallstone is being passed and is blocking a Bile duct?
Biliary colic
What are the treatments for minor and major symptomatic pts for cholelithiasis?
Minor symptoms - Pain relief & dietary control to reduce fat
Major symptoms - Surgery, typically laproscopic cholecystectomy
What is choledocholithiasis?
Presence of gallstones in the CBD or hepatic duct
choledocho = occurring in the CBD
lithiasis = formation of stones
What are some symptoms of choledocholithiasis?
- Biliary colic
- Cholangitis with fever, chills & jaundice (aka Charcot triad)
- Loss of appetite, nausea and vomiting
- Acute gallstone pancreatitis
What symptoms is associated with Charcot triad?
Cholangitis with fever, chills and jaundice
Acalculous cholecystitis is inflammation of the gallbladder without evidence of gallstones.
Treatment consists of:
1.
2.
- Urgent cholecystectomy or cholecystostomy
2. Antibiotics
What is cholangitis?
Bacterial infection of the bile duct often associated with choledocholithiasis (gallstones in CBD).
It can also be associated with: cancer tumor stricture and other
Cholangitis is a medical and surgical emergency requiring IV hydration, antibiotics and drainage of biliary tree. 🌳
What is the term used for acute or chronic inflammation that causes painful distention of the gallbladder?
Cholecystitis
chole = Bile duct or gall cystitis = inflammation of the bladder
Treatment: cholecystectomy
What is primary sclerosing cholangitis? (PSC)
Inflammation of the bile ducts causes scarring and then stricturing.
This blockage in bile flow will result in gradual liver cell damage or cirrhosis.
Treatment may consist of nothing for minor PSC or endoscopic Dilatation or placement of Biliary Stent.
Etiology is unknown.
The gallbladder wall is made up of:
Serosa, a fibromuscular layer and mucosa
By far the most common disease affecting the Biliary system is:
a. Choledocholithiasis
b. Cholecystitis
c. Cholelithiasis
d. Cholangitis
c. Cholelithiasis
