The gallbladder is a pear-shaped organ located beneath the liver that stores and concentrates bile. Gallstones are solid deposits that can form in the gallbladder from cholesterol, bilirubin, or calcium salts. Risk factors for gallstones include obesity, rapid weight loss, female gender, and certain medical conditions. Gallstones may be asymptomatic or can cause symptoms like biliary colic, cholecystitis, pancreatitis, and jaundice. Diagnosis involves ultrasound or CT imaging. Treatment is typically laparoscopic cholecystectomy to surgically remove the gallbladder for symptomatic or complicated cases. Complications after cholecystectomy can include bile leaks, hemorrhage, or infections.
The document describes the anatomy and pathophysiology of gallstones (cholelithiasis). It details the anatomy of the gallbladder and biliary ductal system. It explains the formation of cholesterol stones and pigment stones, and lists risk factors for gallstone development. Potential complications are outlined, including biliary colic, cholecystitis, pancreatitis, and jaundice. Diagnosis involves ultrasound and liver function tests. Treatment typically involves cholecystectomy for symptomatic patients.
Gallbladder disorders include cholelithiasis, acute cholecystitis, and chronic cholecystitis. Cholelithiasis refers to gallstones, which form from bile constituents like cholesterol and pigment in the gallbladder or bile ducts. Risk factors include age, female sex, obesity, family history, and estrogen therapy. Acute cholecystitis is inflammation of the gallbladder due to gallstones obstructing the cystic duct or gallbladder neck. Symptoms include right upper quadrant pain, nausea, and fever. Chronic cholecystitis results from repeated inflammation and infection leading to gallbladder fibrosis. Treatment involves antibiotics, pain management, and cholecystectomy for severe or recurrent cases
The document discusses diseases of the gallbladder and biliary tree. It describes the anatomy and physiology of the gallbladder and discusses conditions like gallstones, acute cholecystitis, and obstructive jaundice. Gallstones are the most common pathology of the biliary tract and can cause complications within the gallbladder or bile ducts. Acute cholecystitis is an inflammation of the gallbladder usually due to a gallstone obstructing the cystic duct. Obstructive jaundice is caused by an obstruction of the biliary tree above the entry of the pancreatic duct and results in a yellowish discoloration of skin and eyes.
This document provides information on obstructive jaundice, including:
- Causes of obstructive jaundice include gallstones, tumors, strictures.
- Clinical features include jaundice, itching, steatorrhea.
- Investigations include liver function tests, ultrasound, CT, MRCP, ERCP.
- ERCP allows both diagnosis and treatment by sphincterotomy and stone extraction.
- Surgical management of stones includes open exploration or laparoscopic removal.
- Benign strictures are often post-surgical and may require stenting or reconstruction.
This document summarizes a seminar on cholecystitis and choledocholithiasis presented by Ms. Navaneeta Kusum. It discusses the topics of:
1) Cholecystitis, which is inflammation of the gallbladder often caused by gallstones blocking bile flow, and choledocholithiasis, which are stones in the common bile duct.
2) Risk factors, signs and symptoms, diagnostic evaluations and complications of both conditions.
3) Treatment options including conservative management, definitive surgery such as cholecystectomy and bile duct exploration, and nonsurgical options like oral dissolution therapy.
This document provides an overview of gallbladder and biliary diseases. It discusses gallbladder anatomy and physiology, cholelithiasis (gallstone formation), complications of gallstones like cholecystitis, choledocholithiasis, and gallbladder cancer. It also covers obstructive jaundice, describing bilirubin metabolism and different causes of obstruction like gallstones, strictures, and pancreatic masses. The clinical features of obstructive jaundice are jaundice, dark urine, pale stool and abdominal pain. Investigations include liver function tests and imaging like ultrasound or CT to identify the cause of obstruction.
This document discusses obstructive jaundice and approaches to evaluation. It begins by describing the history and definitions of jaundice and obstructive jaundice. It then discusses the effects of biliary obstruction on various organ systems including the intestines, coagulation, renal, hepatic, and dermatologic systems. The document outlines the clinical evaluation of a patient with obstructive jaundice including history, examination, and initial investigations. It proposes an algorithm for imaging based on ultrasound findings and evaluates modalities like CT, MRCP, ERCP, EUS, and percutaneous transhepatic cholangiography.
Oriental Cholangiohepatitis (OCH) PresentationNaeem Ahmad
This document discusses oriental cholangiohepatitis (OCH), a syndrome characterized by recurrent bouts of cholangitis caused by intrahepatic and extrahepatic stones, biliary duct strictures, and liver parenchymal atrophy. It is predominantly seen in Southeast Asia. The exact etiology is unknown but is likely multifactorial involving parasites such as Clonorchis sinensis and Ascaris lumbricoides, which can invade the bile ducts and cause infection, duct damage, and stone formation over time. Imaging studies like ultrasound, CT, MRCP, and cholangiography are used to detect duct abnormalities, strictures, and stones. Treatment involves controlling biliary sepsis during acute episodes
The document describes the anatomy and pathophysiology of gallstones (cholelithiasis). It details the anatomy of the gallbladder and biliary ductal system. It explains the formation of cholesterol stones and pigment stones, and lists risk factors for gallstone development. Potential complications are outlined, including biliary colic, cholecystitis, pancreatitis, and jaundice. Diagnosis involves ultrasound and liver function tests. Treatment typically involves cholecystectomy for symptomatic patients.
Gallbladder disorders include cholelithiasis, acute cholecystitis, and chronic cholecystitis. Cholelithiasis refers to gallstones, which form from bile constituents like cholesterol and pigment in the gallbladder or bile ducts. Risk factors include age, female sex, obesity, family history, and estrogen therapy. Acute cholecystitis is inflammation of the gallbladder due to gallstones obstructing the cystic duct or gallbladder neck. Symptoms include right upper quadrant pain, nausea, and fever. Chronic cholecystitis results from repeated inflammation and infection leading to gallbladder fibrosis. Treatment involves antibiotics, pain management, and cholecystectomy for severe or recurrent cases
The document discusses diseases of the gallbladder and biliary tree. It describes the anatomy and physiology of the gallbladder and discusses conditions like gallstones, acute cholecystitis, and obstructive jaundice. Gallstones are the most common pathology of the biliary tract and can cause complications within the gallbladder or bile ducts. Acute cholecystitis is an inflammation of the gallbladder usually due to a gallstone obstructing the cystic duct. Obstructive jaundice is caused by an obstruction of the biliary tree above the entry of the pancreatic duct and results in a yellowish discoloration of skin and eyes.
This document provides information on obstructive jaundice, including:
- Causes of obstructive jaundice include gallstones, tumors, strictures.
- Clinical features include jaundice, itching, steatorrhea.
- Investigations include liver function tests, ultrasound, CT, MRCP, ERCP.
- ERCP allows both diagnosis and treatment by sphincterotomy and stone extraction.
- Surgical management of stones includes open exploration or laparoscopic removal.
- Benign strictures are often post-surgical and may require stenting or reconstruction.
This document summarizes a seminar on cholecystitis and choledocholithiasis presented by Ms. Navaneeta Kusum. It discusses the topics of:
1) Cholecystitis, which is inflammation of the gallbladder often caused by gallstones blocking bile flow, and choledocholithiasis, which are stones in the common bile duct.
2) Risk factors, signs and symptoms, diagnostic evaluations and complications of both conditions.
3) Treatment options including conservative management, definitive surgery such as cholecystectomy and bile duct exploration, and nonsurgical options like oral dissolution therapy.
This document provides an overview of gallbladder and biliary diseases. It discusses gallbladder anatomy and physiology, cholelithiasis (gallstone formation), complications of gallstones like cholecystitis, choledocholithiasis, and gallbladder cancer. It also covers obstructive jaundice, describing bilirubin metabolism and different causes of obstruction like gallstones, strictures, and pancreatic masses. The clinical features of obstructive jaundice are jaundice, dark urine, pale stool and abdominal pain. Investigations include liver function tests and imaging like ultrasound or CT to identify the cause of obstruction.
This document discusses obstructive jaundice and approaches to evaluation. It begins by describing the history and definitions of jaundice and obstructive jaundice. It then discusses the effects of biliary obstruction on various organ systems including the intestines, coagulation, renal, hepatic, and dermatologic systems. The document outlines the clinical evaluation of a patient with obstructive jaundice including history, examination, and initial investigations. It proposes an algorithm for imaging based on ultrasound findings and evaluates modalities like CT, MRCP, ERCP, EUS, and percutaneous transhepatic cholangiography.
Oriental Cholangiohepatitis (OCH) PresentationNaeem Ahmad
This document discusses oriental cholangiohepatitis (OCH), a syndrome characterized by recurrent bouts of cholangitis caused by intrahepatic and extrahepatic stones, biliary duct strictures, and liver parenchymal atrophy. It is predominantly seen in Southeast Asia. The exact etiology is unknown but is likely multifactorial involving parasites such as Clonorchis sinensis and Ascaris lumbricoides, which can invade the bile ducts and cause infection, duct damage, and stone formation over time. Imaging studies like ultrasound, CT, MRCP, and cholangiography are used to detect duct abnormalities, strictures, and stones. Treatment involves controlling biliary sepsis during acute episodes
The patient, a 57-year-old woman, presented with right upper quadrant pain and tenderness and was found to have gallstones. Gallstones form when bile in the gallbladder becomes supersaturated, causing cholesterol and other substances to precipitate out into stones. Risk factors include female gender, multiparity, obesity, and genetics. Ultrasound confirmed the presence of gallstones and showed a thick-walled gallbladder, indicating cholecystitis. Treatment options include dissolving the stones medically, surgical removal by cholecystectomy, or nonsurgical methods such as lithotripsy to break up the stones.
This document discusses surgical jaundice, including:
1. It defines jaundice and surgical jaundice, and classifies jaundice into pre-hepatic, hepatic, and post-hepatic types.
2. It describes the anatomy and physiology of the biliary tract and bilirubin metabolism.
3. Common causes of obstructive jaundice include gallstones, cancer, strictures, and inflammation. A thorough history and physical exam can help identify the cause.
4. Investigations include blood tests, imaging like ultrasound and MRCP, and procedures like ERCP. The goal is to determine the specific cause and level of obstruction.
5. Treatment depends on the
PPT on Neonatal cholestasis by Dr.ajay k chourasiaAjay Kumar
This document provides an overview of neonatal cholestasis, including its definition, classification, and causes. It discusses infectious, metabolic, genetic/chromosomal, and other potential etiologies. Specific conditions are described in more detail such as Alagille syndrome, progressive familial intrahepatic cholestasis types 1-3, and Zellweger syndrome. Evaluation and management goals are to diagnose and treat underlying conditions, identify those amenable to surgery, and avoid unnecessary procedures for intrahepatic diseases.
The document discusses cholelithiasis (gallstones) and acute cholecystitis (inflammation of the gallbladder). It covers the prevalence and types of gallstones, risk factors, potential complications, clinical presentation, diagnosis and treatment options. For acute cholecystitis, conservative treatment with antibiotics and fluids is usually attempted first to resolve the inflammation before delayed cholecystectomy once symptoms subside.
The document discusses cholecystitis and cholelithiasis. It begins by reviewing the anatomy of the gallbladder and its connection to the liver and bile ducts. It then defines cholecystitis as inflammation of the gallbladder, which can be acute or chronic, and calculous or acalculous. The pathophysiology of calculous cholecystitis involves gallstones obstructing bile flow and damaging the gallbladder walls. Clinical features include pain in the upper right abdomen and fever. The document also defines cholelithiasis as gallstone formation, discusses the types of gallstones, risk factors like obesity and genetics, and the pathophysiology of cholesterol crystals forming in supersaturated bile and
Gastric outlet obstruction has various causes, both benign and malignant. Benign causes include peptic ulcer disease and gastric polyps, while pancreatic cancer is the most common malignant cause. Patients present with non-bilious vomiting, weight loss, and dehydration. Diagnosis involves imaging studies and endoscopy. Treatment involves rehydration, nutritional support, and surgery if medical management fails or for malignant obstructions. Surgical options include vagotomy with gastrojejunostomy. Complications can include perforation from endoscopic procedures or anastomotic leak from surgery due to patient malnutrition.
A quick review of the various benign pathologic conditions of Gallbladder,intended primarily for the Undergraduate students; Based on Bailey & Love's Short Practise of Surgery latest edition.
Dr.Saad Gall Bladder and Biliary Tract2022.pptxGgdcddede
This document provides an overview of the surgical anatomy, physiology, investigations, congenital anomalies, diseases, and procedures related to the gallbladder and biliary system. It discusses the anatomy of the gallbladder, cystic duct, common hepatic duct, and common bile duct. It also summarizes the arterial supply, lymphatic drainage, and functions of the gallbladder. Various congenital anomalies, diseases like gallstones, calculus cholecystitis, and tumors are described. Surgical procedures for conditions like cholecystectomy, bile duct obstruction, and strictures are outlined.
The document provides information on the anatomy, physiology, causes, symptoms, signs, and diagnostic criteria for acute pancreatitis. It describes the anatomy of the pancreas and discusses the hormones that stimulate pancreatic secretion such as secretin and cholecystokinin. Common causes of acute pancreatitis include alcohol, gallstones, trauma, drugs, infections, and hyperlipidemia. Symptoms include severe epigastric pain that radiates to the back while signs include fever, abdominal tenderness, and grey turner sign. Laboratory tests and criteria such as Ranson's are used to determine severity and prognosis.
This document discusses surgical jaundice, defined as jaundice that can be treated surgically, usually due to extrahepatic biliary obstruction. It covers the definition, causes, pathophysiology, clinical evaluation and treatment of surgical jaundice. The most common cause is gallstones, which can become lodged in the common bile duct. Physical examination may reveal jaundice and abdominal tenderness. Imaging studies can locate the obstruction and determine if it is intrahepatic or extrahepatic. Treatment involves addressing the underlying cause, often through surgery such as cholecystectomy for gallstones or bypass procedures for cancer.
This document provides an overview of gastric outlet obstruction (GOO). It discusses that GOO can result from benign or malignant causes that obstruct gastric emptying. The most common benign causes are peptic ulcer disease and gastric polyps, while pancreatic cancer is the most common malignant cause. Patients present with nausea, vomiting, weight loss, and dehydration. Diagnosis involves distinguishing mechanical from functional causes, and benign from malignant etiologies. Treatment depends on the underlying cause, with surgery considered for benign cases unresponsive to medical management or in select malignant cases for palliation.
Medical Surgical Nursing - I
UNIT: IV -Nursing Management of Patients With Disorder of Digestive System "Cirrhosis of liver"
the topic covers
- the stages, Pathophysiology and clinical manifestation of Cirrhosis of liver
- diagnostic evaluation and complication of Cirrhosis of liver
- medical, surgical and nursing management of patient with Cirrhosis of liver
Congenital anamalies of biliary system aryajaRamesh Bhat
This document discusses various congenital anomalies of the biliary system. It describes abnormalities that can occur in the gallbladder, hepatic ducts, cystic duct, arteries, and other structures. Some key points include:
- The gallbladder may be absent, duplicated, located on the left side, or intrahepatic.
- Accessory hepatic ducts occur in around 15% of cases.
- Variations can occur in the origins of the cystic and hepatic arteries.
- The cystic duct can drain into various locations and have other anomalies.
- Choledochal cysts are cystic dilations that can affect different parts of the biliary tree.
- Congenital biliary at
1. The document discusses obstructive jaundice, describing its causes as being related to blockage of bile flow from the liver. This can be caused by gallstones, pancreatic cancer, or other tumors.
2. Clinical features include jaundice, abdominal pain, and elevated bilirubin levels. Imaging tests like ultrasound, CT, MRCP, and ERCP can help locate and identify obstructions.
3. Treatment depends on the underlying cause but may involve surgery to remove gallstones or tumors, or ERCP to clear ducts endoscopically. Prognosis depends on factors like type of obstruction and patient health.
The liver produces bile which is stored and concentrated in the gallbladder before being released to aid in fat digestion. Gallstones form when bile contains too much cholesterol or bilirubin. Risk factors for gallstones include female sex, obesity, rapid weight loss, and family history. Gallbladder disorders in children can include cholecystitis, cholelithiasis, sludge, polyps, and septations. Symptoms include abdominal pain. Ultrasound can detect gallstones, wall thickening, sludge, and other abnormalities.
Biliary atresia is a condition where the bile ducts inside and outside the liver are scarred and blocked. This prevents bile from draining from the liver to the small intestine. It usually appears in infants within the first 2 months of life with jaundice, pale stools, and liver enlargement. Diagnosis involves blood tests, imaging, and biopsy. The standard treatment is the Kasai procedure to reconstruct bile drainage, but transplantation may be needed for advanced scarring. Life-long monitoring is required as complications can include infections, bleeding, and liver failure.
The document discusses cholelithiasis (gallstone disease). It describes the anatomy and physiology of the gallbladder, including its structure and function of storing and releasing bile. Gallstones form when there is a change in the composition of bile leading to precipitation of cholesterol, calcium, or bilirubin crystals. Risk factors include hereditary factors, obesity, rapid weight loss, and certain medical conditions. Symptoms include abdominal pain, nausea, vomiting, and jaundice. Treatment options include medical management with pain medications or stone dissolution agents, or surgical removal of the gallbladder via laparoscopic cholecystectomy.
Sectional dentures for microstomia patients.pptxSatvikaPrasad
Microstomia, characterized by an abnormally small oral aperture, presents significant challenges in prosthodontic treatment, including limited access for examination, difficulties in impression making, and challenges with prosthesis insertion and removal. To manage these issues, customized impression techniques using sectional trays and elastomeric materials are employed. Prostheses may be designed in segments or with flexible materials to facilitate handling. Minimally invasive procedures and the use of digital technologies can enhance patient comfort. Education and training for patients on prosthesis care and maintenance are crucial for compliance. Regular follow-up and a multidisciplinary approach, involving collaboration with other specialists, ensure comprehensive care and improved quality of life for microstomia patients.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...rightmanforbloodline
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
The patient, a 57-year-old woman, presented with right upper quadrant pain and tenderness and was found to have gallstones. Gallstones form when bile in the gallbladder becomes supersaturated, causing cholesterol and other substances to precipitate out into stones. Risk factors include female gender, multiparity, obesity, and genetics. Ultrasound confirmed the presence of gallstones and showed a thick-walled gallbladder, indicating cholecystitis. Treatment options include dissolving the stones medically, surgical removal by cholecystectomy, or nonsurgical methods such as lithotripsy to break up the stones.
This document discusses surgical jaundice, including:
1. It defines jaundice and surgical jaundice, and classifies jaundice into pre-hepatic, hepatic, and post-hepatic types.
2. It describes the anatomy and physiology of the biliary tract and bilirubin metabolism.
3. Common causes of obstructive jaundice include gallstones, cancer, strictures, and inflammation. A thorough history and physical exam can help identify the cause.
4. Investigations include blood tests, imaging like ultrasound and MRCP, and procedures like ERCP. The goal is to determine the specific cause and level of obstruction.
5. Treatment depends on the
PPT on Neonatal cholestasis by Dr.ajay k chourasiaAjay Kumar
This document provides an overview of neonatal cholestasis, including its definition, classification, and causes. It discusses infectious, metabolic, genetic/chromosomal, and other potential etiologies. Specific conditions are described in more detail such as Alagille syndrome, progressive familial intrahepatic cholestasis types 1-3, and Zellweger syndrome. Evaluation and management goals are to diagnose and treat underlying conditions, identify those amenable to surgery, and avoid unnecessary procedures for intrahepatic diseases.
The document discusses cholelithiasis (gallstones) and acute cholecystitis (inflammation of the gallbladder). It covers the prevalence and types of gallstones, risk factors, potential complications, clinical presentation, diagnosis and treatment options. For acute cholecystitis, conservative treatment with antibiotics and fluids is usually attempted first to resolve the inflammation before delayed cholecystectomy once symptoms subside.
The document discusses cholecystitis and cholelithiasis. It begins by reviewing the anatomy of the gallbladder and its connection to the liver and bile ducts. It then defines cholecystitis as inflammation of the gallbladder, which can be acute or chronic, and calculous or acalculous. The pathophysiology of calculous cholecystitis involves gallstones obstructing bile flow and damaging the gallbladder walls. Clinical features include pain in the upper right abdomen and fever. The document also defines cholelithiasis as gallstone formation, discusses the types of gallstones, risk factors like obesity and genetics, and the pathophysiology of cholesterol crystals forming in supersaturated bile and
Gastric outlet obstruction has various causes, both benign and malignant. Benign causes include peptic ulcer disease and gastric polyps, while pancreatic cancer is the most common malignant cause. Patients present with non-bilious vomiting, weight loss, and dehydration. Diagnosis involves imaging studies and endoscopy. Treatment involves rehydration, nutritional support, and surgery if medical management fails or for malignant obstructions. Surgical options include vagotomy with gastrojejunostomy. Complications can include perforation from endoscopic procedures or anastomotic leak from surgery due to patient malnutrition.
A quick review of the various benign pathologic conditions of Gallbladder,intended primarily for the Undergraduate students; Based on Bailey & Love's Short Practise of Surgery latest edition.
Dr.Saad Gall Bladder and Biliary Tract2022.pptxGgdcddede
This document provides an overview of the surgical anatomy, physiology, investigations, congenital anomalies, diseases, and procedures related to the gallbladder and biliary system. It discusses the anatomy of the gallbladder, cystic duct, common hepatic duct, and common bile duct. It also summarizes the arterial supply, lymphatic drainage, and functions of the gallbladder. Various congenital anomalies, diseases like gallstones, calculus cholecystitis, and tumors are described. Surgical procedures for conditions like cholecystectomy, bile duct obstruction, and strictures are outlined.
The document provides information on the anatomy, physiology, causes, symptoms, signs, and diagnostic criteria for acute pancreatitis. It describes the anatomy of the pancreas and discusses the hormones that stimulate pancreatic secretion such as secretin and cholecystokinin. Common causes of acute pancreatitis include alcohol, gallstones, trauma, drugs, infections, and hyperlipidemia. Symptoms include severe epigastric pain that radiates to the back while signs include fever, abdominal tenderness, and grey turner sign. Laboratory tests and criteria such as Ranson's are used to determine severity and prognosis.
This document discusses surgical jaundice, defined as jaundice that can be treated surgically, usually due to extrahepatic biliary obstruction. It covers the definition, causes, pathophysiology, clinical evaluation and treatment of surgical jaundice. The most common cause is gallstones, which can become lodged in the common bile duct. Physical examination may reveal jaundice and abdominal tenderness. Imaging studies can locate the obstruction and determine if it is intrahepatic or extrahepatic. Treatment involves addressing the underlying cause, often through surgery such as cholecystectomy for gallstones or bypass procedures for cancer.
This document provides an overview of gastric outlet obstruction (GOO). It discusses that GOO can result from benign or malignant causes that obstruct gastric emptying. The most common benign causes are peptic ulcer disease and gastric polyps, while pancreatic cancer is the most common malignant cause. Patients present with nausea, vomiting, weight loss, and dehydration. Diagnosis involves distinguishing mechanical from functional causes, and benign from malignant etiologies. Treatment depends on the underlying cause, with surgery considered for benign cases unresponsive to medical management or in select malignant cases for palliation.
Medical Surgical Nursing - I
UNIT: IV -Nursing Management of Patients With Disorder of Digestive System "Cirrhosis of liver"
the topic covers
- the stages, Pathophysiology and clinical manifestation of Cirrhosis of liver
- diagnostic evaluation and complication of Cirrhosis of liver
- medical, surgical and nursing management of patient with Cirrhosis of liver
Congenital anamalies of biliary system aryajaRamesh Bhat
This document discusses various congenital anomalies of the biliary system. It describes abnormalities that can occur in the gallbladder, hepatic ducts, cystic duct, arteries, and other structures. Some key points include:
- The gallbladder may be absent, duplicated, located on the left side, or intrahepatic.
- Accessory hepatic ducts occur in around 15% of cases.
- Variations can occur in the origins of the cystic and hepatic arteries.
- The cystic duct can drain into various locations and have other anomalies.
- Choledochal cysts are cystic dilations that can affect different parts of the biliary tree.
- Congenital biliary at
1. The document discusses obstructive jaundice, describing its causes as being related to blockage of bile flow from the liver. This can be caused by gallstones, pancreatic cancer, or other tumors.
2. Clinical features include jaundice, abdominal pain, and elevated bilirubin levels. Imaging tests like ultrasound, CT, MRCP, and ERCP can help locate and identify obstructions.
3. Treatment depends on the underlying cause but may involve surgery to remove gallstones or tumors, or ERCP to clear ducts endoscopically. Prognosis depends on factors like type of obstruction and patient health.
The liver produces bile which is stored and concentrated in the gallbladder before being released to aid in fat digestion. Gallstones form when bile contains too much cholesterol or bilirubin. Risk factors for gallstones include female sex, obesity, rapid weight loss, and family history. Gallbladder disorders in children can include cholecystitis, cholelithiasis, sludge, polyps, and septations. Symptoms include abdominal pain. Ultrasound can detect gallstones, wall thickening, sludge, and other abnormalities.
Biliary atresia is a condition where the bile ducts inside and outside the liver are scarred and blocked. This prevents bile from draining from the liver to the small intestine. It usually appears in infants within the first 2 months of life with jaundice, pale stools, and liver enlargement. Diagnosis involves blood tests, imaging, and biopsy. The standard treatment is the Kasai procedure to reconstruct bile drainage, but transplantation may be needed for advanced scarring. Life-long monitoring is required as complications can include infections, bleeding, and liver failure.
The document discusses cholelithiasis (gallstone disease). It describes the anatomy and physiology of the gallbladder, including its structure and function of storing and releasing bile. Gallstones form when there is a change in the composition of bile leading to precipitation of cholesterol, calcium, or bilirubin crystals. Risk factors include hereditary factors, obesity, rapid weight loss, and certain medical conditions. Symptoms include abdominal pain, nausea, vomiting, and jaundice. Treatment options include medical management with pain medications or stone dissolution agents, or surgical removal of the gallbladder via laparoscopic cholecystectomy.
Sectional dentures for microstomia patients.pptxSatvikaPrasad
Microstomia, characterized by an abnormally small oral aperture, presents significant challenges in prosthodontic treatment, including limited access for examination, difficulties in impression making, and challenges with prosthesis insertion and removal. To manage these issues, customized impression techniques using sectional trays and elastomeric materials are employed. Prostheses may be designed in segments or with flexible materials to facilitate handling. Minimally invasive procedures and the use of digital technologies can enhance patient comfort. Education and training for patients on prosthesis care and maintenance are crucial for compliance. Regular follow-up and a multidisciplinary approach, involving collaboration with other specialists, ensure comprehensive care and improved quality of life for microstomia patients.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...rightmanforbloodline
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
India Medical Devices Market: Size, Share, and In-Depth Competitive Analysis ...Kumar Satyam
According to TechSci Research report, “India Medical Devices Market Industry Size, Share, Trends, Competition, Opportunity and Forecast, 2019-2029,” the India Medical Devices Market was valued at USD 15.35 billion in 2023 and is anticipated to witness impressive growth in the forecast period, with a Compound Annual Growth Rate (CAGR) of 5.35% through 2029. This growth is driven by various factors, including strategic collaborations and partnerships among leading companies, a growing population, and the increasing demand for advanced healthcare solutions.
Recent Trends
Strategic Collaborations and Partnerships
One of the most significant trends driving the India Medical Devices Market is the increasing number of collaborations and partnerships among leading companies. These alliances aim to merge the expertise of individual companies to strengthen their market position and enhance their product offerings. For instance, partnerships between local manufacturers and international companies bring advanced technologies and manufacturing techniques to the Indian market, fostering innovation and improving product quality.
Browse over XX market data Figures and spread through XX Pages and an in-depth TOC on " India Medical Devices Market.” - https://www.techsciresearch.com/report/india-medical-devices-market/8161.html
Enhancing Hip and Knee Arthroplasty Precision with Preoperative CT and MRI Im...Pristyn Care Reviews
Precision becomes a byword, most especially in such procedures as hip and knee arthroplasty. The success of these surgeries is not just dependent on the skill and experience of the surgeons but is extremely dependent on preoperative planning. Recognizing this important need, Pristyn Care commits itself to the integration of advanced imaging technologies like CT (Computed Tomography) and MRI (Magnetic Resonance Imaging) into the surgical planning process.
Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...DrDevTaneja1
Digital India will need a big trained army of Health Informatics educated & trained manpower in India.
Presently, generalist IT manpower does most of the work in the healthcare industry in India. Academic Health Informatics education is not readily available at school & health university level or IT education institutions in India.
We look into the evolution of health informatics and its applications in the healthcare industry.
HIMMS TIGER resources are available to assist Health Informatics education.
Indian Health universities, IT Education institutions, and the healthcare industry must proactively collaborate to start health informatics courses on a big scale. An advocacy push from various stakeholders is also needed for this goal.
Health informatics has huge employment potential and provides a big business opportunity for the healthcare industry. A big pool of trained health informatics manpower can lead to product & service innovations on a global scale in India.
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
Ensure the highest quality care for your patients with Cardiac Registry Support's cancer registry services. We support accreditation efforts and quality improvement initiatives, allowing you to benchmark performance and demonstrate adherence to best practices. Confidence starts with data. Partner with Cardiac Registry Support. For more details visit https://cardiacregistrysupport.com/cancer-registry-services/
The Importance of Black Women Understanding the Chemicals in Their Personal C...bkling
Certain chemicals, such as phthalates and parabens, can disrupt the body's hormones and have significant effects on health. According to data, hormone-related health issues such as uterine fibroids, infertility, early puberty and more aggressive forms of breast and endometrial cancers disproportionately affect Black women. Our guest speaker, Jasmine A. McDonald, PhD, an Assistant Professor in the Department of Epidemiology at Columbia University in New York City, discusses the scientific reasons why Black women should pay attention to specific chemicals in their personal care products, like hair care, and ways to minimize their exposure.
Mental Health and well-being Presentation. Exploring innovative approaches and strategies for enhancing mental well-being. Discover cutting-edge research, effective strategies, and practical methods for fostering mental well-being.
VEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdfVedanta A
Air Ambulance Services In Rewa works in close coordination with ground-based emergency services, including local Emergency Medical Services, fire departments, and law enforcement agencies.
More@: https://tinyurl.com/2shrryhx
More@: https://tinyurl.com/5n8h3wp8
English Drug and Alcohol Commissioners June 2024.pptxMatSouthwell1
Presentation made by Mat Southwell to the Harm Reduction Working Group of the English Drug and Alcohol Commissioners. Discuss stimulants, OAMT, NSP coverage and community-led approach to DCRs. Focussing on active drug user perspectives and interests
R3 Stem Cell Therapy: A New Hope for Women with Ovarian FailureR3 Stem Cell
Discover the groundbreaking advancements in stem cell therapy by R3 Stem Cell, offering new hope for women with ovarian failure. This innovative treatment aims to restore ovarian function, improve fertility, and enhance overall well-being, revolutionizing reproductive health for women worldwide.
Fit to Fly PCR Covid Testing at our Clinic Near YouNX Healthcare
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Research, Monitoring and Evaluation, in Public Healthaghedogodday
This is a presentation on the overview of the role of monitoring and evaluation in public health. It describes the various components and how a robust M&E system can possitively impact the results or effectiveness of a public health intervention.
2. ANATOMY OF GALL BLADDER
▶ Pear shaped structure
▶Lies on the underside of the liver in the main liver scissura
at the junction of right and left lobe of the liver
▶ 7.5-12 cm long
▶ NORMAL CAPACITY 25-30 ml
▶ Anatomically divided into three parts:
a) FUNDUS
b) BODY
c) NECK
3. ▶Muscle fibres in the wall of the gall bladder
are arranged in crisscross manner, being
particularly well developed in neck.
▶Cystic duct
1. 3cm in length
2. Lumen is 1-3cm in length
3. Mucosa of cystic duct arranged in variable
folds known as “VALVES OF HEISTER”
4. 4) Wall of cystic duct surrounded by sphincteric structure
called “VALVES OF HEISTER”
▶ Common hepatic duct
1. usually 2.5cm long
2. Formed by union of right and left hepatic ducts
▶ Common bile duct
1. 7.5 cm long
2. Formed by junction of cystic and common hepatic ducts
5.
6. CALOT’S TRIANGLE
▶ It is space bordered by:
a) cystic duct inferiorly
b) common hepatic duct medially
c) superior border of cystic artery
▶ important surgical landmark
▶should be identified by surgeons performing a
cholecystectomy to avoid damage to the extrahepatic
biliary system
7.
8. FUNCTIONS OF GALL BLADDER
▶Reservoir for bile
▶Concentration of bile by active
absorption of water, sodium chloride and
bicarbonate by the mucous membrane of
the gall bladder.
▶Secretion of mucous approx 20ml/day
9. GALL STONES(CHOLELITHIASIS)
▶Most common biliary pathology.
▶Affects 10-15% of the population in western
societies.
▶Asymptomatic in more then 80% of cases
▶1-2% of asymptomatic patients will develop
symptoms requiring surgery per year.
▶It makes cholecystectomy one of the most
common operation performed by general
surgeons
10.
11. TYPES OF GALLSTONES
▶There are three types of gallstones:
1. CHOLESTROL STONES (6%) : Radiating crystal
like appearance
2. MIXED STONES(90%) : Contains cholesterol ,
calcium salts of phosphate & carbonate
,proteins , bile acid, bile pigments,
phospholipids
3. PIGMENT STONES : Small, black or greenish
black, may be soft & sludge like or hard & coral
like.
14. ▶Can occur in BOTH SEXES
▶Quite often in EARLY AGES(even in
childhood)
▶More common in OLD AGES
▶MULTIFACTORIAL
▶Common in western countries and
northern INDIA
15. PATHOGENISIS OF CHOLELITHIASIS
Stone formation takes place.
Precipitation of insoluble cholesterol
Reduces micelle concentration
Altered levels of cholesterol, bile salts, lecithin
Solubility is determined by concentration of cholesterol, bile salts and lecithin
1) METABOLIC
Cholesterol is synthesized in liver.
16. Cholesterol monohydrate stone formation
Crystallization
Insoluble cholesterol
Makes inadequate micelle
Bile gets supersaturated
If cholesterol component increases
• Normal ratio of bile salt & lecithin : cholesterol = 25:1
Ratio below 13:1 leads to precipitation of cholesterol
Insoluble cholesterol is within the soluble micelle(lecithin & bile salts)
17. 2)Infections and infestations
▶BACTERIA – E.coli and salmonella
▶PARASITES – clonarchis sinensis and
ascaris lumbricoids
▶MOYNIHAN’S APHORISM- ‘ a gallstone
is a tombstone erected in the memory of
the organism within it’
18. 3) BILE STAISIS
▶Occurs due to :
a) ESTROGEN therapy
b) PREGNANCY
c) VAGOTOMY
d) Patient who are on LONG TERM I.V
FLUID
19. 4) INCREASED BILIRUBIN
PRODUCTION
▶ Due to any of the causes of haemolysis as in :
A. HERIDITARY SPHEROCYTOSIS
B. SICKEL CELL ANEMIA
C. THALESSEMIA
D. MALARIA
E. CIRRHOSIS
20. ▶Rarely centre of the stone contains radiolucent gas, it
is either
i. TRIRADIATE ( MERCEDES BENZ SIGN)
ii. BIRADIATE (SEAGULL SIGN)
▶1) 10% GALLSTONES are RADIO-OPAQUE
2) 90% GALLSTONES are RADIOLUCENT
▶In some of the cases gallbladder may be filled with
‘TOOTHPASTE’ like material i.e. mixture of calcium
carbonate and phosphate, which on X-RAY(plain)
looks like an OPACIFIED gallbladder( also called
LIMEY GALLBLADDER)
21. CASUAL FACTORS IN GALLSTONE
FORMATION
▶PIGMENT STONE contain less than
30% cholestrol.
▶It is of two types:
i. BLACK stones
ii. BROWN stones
22. BLACK STONES
▶ Composed of insoluble bilirubin pigment polymer , mixed with
calcium phosphate and calcium bicarbonate.
▶ 20%-30% stones are black
▶ Incidence rise with age
▶ BLACK stones are associated with :
a. Haemolysis
b. Usually hereditary
c. Spherocytosis
d. Sickle cell disease
▶ Patient with CIRRHOSIS have a higher instance of PIGMENTED
STONES
23. BROWN STONES
▶ Contains:
i. Calcium bilirubinate
ii. Calcium palmitate
iii. Calcium stearate
iv. Cholesterol
▶ Rare in gall bladder
▶ Form in bile duct
▶Also associated with the presence of foreign bodies with
the bile ducts such as parasites like ascaris lumbricoids.
24.
25. EFFECTS OF THE GALLSTONES
1. IN THE GALL BLADDER
▶Silent asymptomatic stones occurs in :
A. 10% of males
B. 20% of females
26. ▶ BILARY COLIC WITH PERIODICITY
1. Present in 10-25% of patients
2. Severe within hours after meal
3. Dull and constant
4. Spasmodic pain
5. Severe in nature
6. In right upper quadrant and epigastrium, radiating towards chest and
shoulder
7. Generally starts at night, wakes the patient.
8. Precipitated by heavy meal
9. Fever and increased WBC count may be observed.
27. 2) IN THE COMMON BILE DUCT
▶ Secondary common bile duct stones
▶ Cholangitis
▶ Pancreatitis
▶ Mirzzi syndrome(compression of CHD/CBD by stone from cystic duct)
▶ Jaundice may result if the stone migrates from the gallbladder and obstructs the
common bile duct.
3) IN THE INTESTINE
▶ CHOLECYSTODUODENAL FISTULA causing gallstone ileus and intestinal
obstruction
28. EFFECTS AND COMPLICATIONS OF
GALLSTONES
▶ BILARY COLIC
▶ ACUTE CHOLECYSTITIS
▶ CHRONIC CHOLECYSTITIS
▶ GALLSTONE PANCREATITIS
▶ OBSTRUCTIVE JAUNDICE
▶ ACUTE CHOLANGITIS
▶ INTESTINAL OBSTRUCTION ( gallstone ileus)
▶ MUCOCELE / EMPYEMA OF GALL BLADDER
29. BILARY COLIC
▶Episodic pain in epigastrium
▶Pain radiates to lower pole of scapula
▶Patients suffers from :
1. Sweating
2. Nausea
3. Vomiting
▶Intermittent jaundice with pale stool and dark
urine.
30. ▶Differential diagnosis
1. Renal colic
2. Intestinal obstruction
3. Angina
▶Pain episode may resolve
1. when stone is passed into common bile duct
2. When stone falls back into the gall bladder
31. ACUTE CHOLECYSTITIS
▶ Severe
▶ Constant
▶ Localized right hypochondrium pain
▶ CLINICAL FEATURES :
a. Fever
b. Toxaemia
c. Rigors
d. Leucocytosis
e. Tenderness in right hypochondrium
f. Murphy’s sign
g. Palpable gallbladder
32. CHRONIC CHOLECYSTITIS
▶Repeated inflammation resulting in fibrosis and
thickening of gallbladder
▶Longstanding dyspepsia with episodic
cholecystitis
▶DIFFERENTIAL DIAGNOSIS
1. Peptic ulcer
2. Hiatus hernia
3. Angina
33. ▶COMPLICATIONS
a) Empyema
b) Perforation
c) Obstructive jaundice
d) Acalculous cholecystitis
▶MURPHY’S SIGN : In acute phase, the patient may
have right upper quadrant tenderness that is
exacerbated during inspiration by the examiner’s
right subcoastal palpation.
34. ▶ Minor episodes of same discomfort may intermittently
during the day.
▶Dyspeptic symptoms may coexist and may be worse after
such an attack
▶ As pain resolves, patient improves and is able to eat and
drink again
▶ Other symptoms include :
1. Dyspepsia
2. Food intolerance
3. Alteration in biliary frequency
35.
36. GALLSTONE PANCREATITIS
▶Due to transient blocking of
ampulla of vater by stone.
▶Especially when stones are small
and numerous.
37. OBSTRUCTIVE JAUNDICE
▶ Acute in onset
▶ Patient having History of pain
▶ Non palpable gallbladder
▶ Courvoisier’s law( Courvoisier’s sign): it states that
in presence of palpably enlarged gallbladder which is
non tender & accompanied with mild painless
jaundice, the cause is unlikely to be gallstones.
38. ACUTE CHOLANGITIS
▶Infection of the bile duct
▶usually caused by bacteria ascending from
its junction with the duodenum.
▶tends to occur if the bile duct is already
partially obstructed by gallstones.
▶CAUSES
1. FEVER
2. JAUNDICE
39. ▶PREDISPOSING FACTORS
1. Stone in common bile duct
2. Biliary stricture
3. Post-ERCP
4. Post- biliary reconstructive procedure
▶Antibiotics and resuscitation followed by
decompression of biliary tree.
40. GALLSTONE ILEUS
▶Obstruction of small bowel by a large gallstone
▶SYMPTOMS
a) Vomiting
b) Abdominal pain
c) Distention
▶SIGNS
a) Abdominal distention
b) Obstructive bowel sounds
42. DIAGNOSIS OF CHOLELITHIASIS
▶ Diagnosis is based on:
1. History
2. Physical examination
3. Confirmatory radiological studies .i.e.
1. transabdominal ultrasonography
2. radionuclide scan
▶ A positive murphy’s sign suggests
1. Acute inflammation
2. Leucocytosis
3. Elevated liver function tests
43. ▶A mass may be palpable as the
omentum walls of an inflamed gall
bladder
▶If resolution does not occur, an
empyema of gall bladder may result.
▶Walls of gall bladder may become
necrotic and perforate , with
development of localised peritonitis.
44. INVESTIGATION
ULTASOUND ABDOMEN
PLAIN X-RAY
LIVER FUNCTION TEST
WBC COUNT
CT SCAN ABDOMEN
LAPROSCOPIC CHOLECYSTECTOMY
OPEN CHOLECYSTECTOMY
45.
46.
47. TREATMENT
▶Patient with asymptomatic gallstones Safe to
observe patient
▶Patient who develop symptoms or complication
cholecystectomy reserved for these kind of
patients
▶Prophylactic cholecystectomy is done as risk of
developing symptoms is increased , done in
patients with:
a) Diabetes
b) Congenital haemolytic anaemia
48. ▶Cholecystectomy is treatment of
choice in patients with :
i. Biliary colic
ii. Cholecystitis
▶In more than 90% of cases :
Symptoms of acute cholecystitis
subside with conservative measures
49. NON – OPERATIVE TREATMENT
▶Based on four principles :
1)NIL PER MOUTH (NPO) & I.V
FLUID administration until pain
resolves
2)Administration of ANALGESICS
50. 3) ADMINISTRATION OF ANTIBIOTICS
CYSTIC DUCT is blocked in most cases
concentration of antibiotics in serum is more
important than its concentration in bile.
Broad spectrum antibiotics is more effective
against gram –ve bacteria
eg: a) gentamicin
b) cefazolin
c) cefuroxime
52. PATIENT IS SUGGESTED TO RETURN HOME AND COME WHEN INFLAMMATION IS
COMPLETELY RESOLVED SO AS TO PERFORM CHOLECYSTECTOMY
CT SCAN PERFORMED
IF CONCERN IS ABOUT PRESENCE OF COMPLICATION, SUCH AS PERFORATION
IF JAUNDICE PRESENT , MRCP PERFORMED TO EXCLUDE CHOLODCHOLITHIASIS
53. CHOLECYSTECTOMY
▶PREPRATION FOR OPERATION
1. Full blood count
2. Renal profile & liver function test
3. Prothrombin time
4. Chest X-RAY & ECG(if over 45yr or medically
indicated)
5. Antibiotic prophylaxis
6. Deep vein thrombosis prophylaxis
7. Informed consent
54. LAPROSCOPIC CHOLECYSTECTOMY
▶ Preparation and indications are same, either performed by laparoscopy or
open technique
▶ It is procedure of choice for majority of patients.
▶ Key is :
1. Open surgery
2. Identification and safe dissection of CALOT’S TRIANGLE
55. OPEN CHOLECYSTECTOMY
▶For patient in whom a laparoscopic
approach is not indicated.
▶For patient whom conversion from
laparoscopic approach is required an
open cholecystectomy is performed.
▶It is done through right subcoastal
KOCHER’S INCISION.