Difference between revisions of "Gallbladder"

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Gallbladder (view source)

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==Cholelithiasis==
==Cholelithiasis==
*[[AKA]] ''gallstones''.
*[[AKA]] ''gallstones''.
===General===
{{Cholelithiasis}}
*Often accompanies [[cholecystitis]]/contributes and/or causes cholecystitis.
*The gallbladder is removed following ''biliary pancreatitis'' ([[gallstone pancreatitis]]) to reduce recurrence risk.<ref name=pmid23181667>{{Cite journal  | last1 = Bouwense | first1 = SA. | last2 = Besselink | first2 = MG. | last3 = van Brunschot | first3 = S. | last4 = Bakker | first4 = OJ. | last5 = van Santvoort | first5 = HC. | last6 = Schepers | first6 = NJ. | last7 = Boermeester | first7 = MA. | last8 = Bollen | first8 = TL. | last9 = Bosscha | first9 = K. | title = Pancreatitis of biliary origin, optimal timing of cholecystectomy (PONCHO trial): study protocol for a randomized controlled trial. | journal = Trials | volume = 13 | issue =  | pages = 225 | month =  | year = 2012 | doi = 10.1186/1745-6215-13-225 | PMID = 23181667 }}</ref><ref name=pmid22470079>{{Cite journal  | last1 = van Baal | first1 = MC. | last2 = Besselink | first2 = MG. | last3 = Bakker | first3 = OJ. | last4 = van Santvoort | first4 = HC. | last5 = Schaapherder | first5 = AF. | last6 = Nieuwenhuijs | first6 = VB. | last7 = Gooszen | first7 = HG. | last8 = van Ramshorst | first8 = B. | last9 = Boerma | first9 = D. | title = Timing of cholecystectomy after mild biliary pancreatitis: a systematic review. | journal = Ann Surg | volume = 255 | issue = 5 | pages = 860-6 | month = May | year = 2012 | doi = 10.1097/SLA.0b013e3182507646 | PMID = 22470079 }}</ref>
*Gallstones may compress the common bile duct - known as ''Mirizzi Syndrome''.<ref name=pmid25672201>{{Cite journal  | last1 = Khalid | first1 = S. | last2 = Bhatti | first2 = AA. | title = Mirizzi's syndrome: an interesting on table finding. | journal = J Ayub Med Coll Abbottabad | volume = 26 | issue = 4 | pages = 621-4 | month =  | year =  | doi =  | PMID = 25672201 }}</ref>
**Can be associated with jaundice.<ref name=pmid25513064>{{Cite journal  | last1 = Elhanafy | first1 = E. | last2 = Atef | first2 = E. | last3 = El Nakeeb | first3 = A. | last4 = Hamdy | first4 = E. | last5 = Elhemaly | first5 = M. | last6 = Sultan | first6 = AM. | title = Mirizzi Syndrome: How it could be a challenge. | journal = Hepatogastroenterology | volume = 61 | issue = 133 | pages = 1182-6 | month =  | year =  | doi =  | PMID = 25513064 }}</ref>
 
The two types of gallstones:
*Cholesterol stones.
*Pigment stones.
 
Note:
*Most stones technically speaking are a mix, i.e. cholesterol and pigment.  Many call yellow stones that are a mix "cholesterol stones".
 
====Epidemiology====
Classic risk factors for gallstones - 4 Fs:<ref name=pmid18540184>{{Cite journal  | last1 = Szwed | first1 = Z. | last2 = Zyciński | first2 = P. | title = [4F's--still up to date risk factors of cholelithiasis]. | journal = Wiad Lek | volume = 60 | issue = 11-12 | pages = 570-3 | month =  | year = 2007 | doi =  | PMID = 18540184 }}</ref>
*'''F'''emale.
*'''F'''at.
*'''F'''orty.
*'''F'''ertile.
 
Additional:
*Family history.
 
====Cholesterol stones====
*More common than pigment stone.
 
Appearance:
*Clear or yellow.
*Opaque or translucent.
*Sometimes shinny.
 
=====Image=====
<gallery>
Image:Gallensteine_2006_03_28.JPG | Yellow gallstones. (WC)
</gallery>
====Pigment stones====
*Due to high [[RBC]] turnover, e.g. [[sickle cell disease]], thalassemia.
*Radio-opaque.<ref>URL: [http://www.rxmed.com/b.main/b2.pharmaceutical/b2.1.monographs/CPS-%20Monographs/CPS-%20%28General%20Monographs-%20U%29/URSOFALK.html http://www.rxmed.com/b.main/b2.pharmaceutical/b2.1.monographs/CPS-%20Monographs/CPS-%20%28General%20Monographs-%20U%29/URSOFALK.html]. Accessed on: 29 October 2011.</ref>
 
Appearance:
*Black - '''key feature'''.
*Dull.
 
===Microscopic===
*Not routinely done on gallstones.
 
===Sign out===
<pre>
GALLBLADDER CHOLECYSTECTOMY:
- CHOLELITHIASIS.
- MILD CHRONIC CHOLECYSTITIS.
</pre>


=Less common pathologic diagnoses=
=Less common pathologic diagnoses=
Michael
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