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Choledocholithiasis
Common bile duct stone, also known as choledocholithiasis, is the presence of gallstones in the common bile duct (CBD) (thus '' choledocho-'' + '' lithiasis''). This condition can cause jaundice and liver cell damage. Treatments include choledocholithotomy and endoscopic retrograde cholangiopancreatography (ERCP). Signs and symptoms Murphy's sign is commonly negative on physical examination in choledocholithiasis, helping to distinguish it from cholecystitis. Jaundice of the skin or eyes is an important physical finding in biliary obstruction. Jaundice and/or clay-colored stool may raise suspicion of choledocholithiasis or even gallstone pancreatitis. If the above symptoms coincide with fever and chills, the diagnosis of ascending cholangitis may also be considered. More than 70% of people with gallstones are asymptomatic and are diagnosed incidentally during ultrasound. Studies have shown that 10% of those with gallstones will develop symptoms within 5 years of diagnosis, and ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Choledocholithotomy
A gallstone is a calculus (medicine), stone formed within the gallbladder from precipitated bile components. The term cholelithiasis may refer to the presence of gallstones or to any disease caused by gallstones, and choledocholithiasis refers to the presence of migrated gallstones within bile ducts. Most people with gallstones (about 80%) are asymptomatic. However, when a gallstone obstructs the bile duct and causes acute cholestasis, a reflexive smooth muscle spasm often occurs, resulting in an intense cramp-like visceral pain in the quadrant (abdomen), right upper part of the abdomen known as a biliary colic (or "gallbladder attack"). This happens in 1–4% of those with gallstones each year. Complications from gallstones may include inflammation of the gallbladder (cholecystitis), inflammation of the pancreas (pancreatitis), Jaundice#Post-hepatic, obstructive jaundice, and infection in bile ducts (ascending cholangitis, cholangitis). Symptoms of these complications may inclu ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Gallstones
A gallstone is a stone formed within the gallbladder from precipitated bile components. The term cholelithiasis may refer to the presence of gallstones or to any disease caused by gallstones, and choledocholithiasis refers to the presence of migrated gallstones within bile ducts. Most people with gallstones (about 80%) are asymptomatic. However, when a gallstone obstructs the bile duct and causes acute cholestasis, a reflexive smooth muscle spasm often occurs, resulting in an intense cramp-like visceral pain in the right upper part of the abdomen known as a biliary colic (or "gallbladder attack"). This happens in 1–4% of those with gallstones each year. Complications from gallstones may include inflammation of the gallbladder (cholecystitis), inflammation of the pancreas (pancreatitis), obstructive jaundice, and infection in bile ducts ( cholangitis). Symptoms of these complications may include pain that lasts longer than five hours, fever, yellowish skin, vomiting, dar ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Endoscopic Retrograde Cholangiopancreatography
Endoscopic retrograde cholangiopancreatography (ERCP) is a technique that combines the use of endoscopy An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are insert ... and fluoroscopy to diagnose and treat certain problems of the bile duct, biliary or pancreatic ductal systems. It is primarily performed by highly skilled and specialty trained gastroenterologists. Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject a contrast medium into the ducts in the biliary tree and/or pancreas so they can be seen on radiography, radiographs. ERCP is used primarily to diagnose and treat conditions of the bile ducts and main pancreatic duct, including gallstones, inflammatory strictures (scars), leaks (from trauma and surgery), and cancer. ERCP can be performed fo ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Common Bile Duct
The common bile duct (also bile duct) is a part of the biliary tract. It is formed by the union of the common hepatic duct and cystic duct. It ends by uniting with the pancreatic duct to form the ampulla of Vater (hepatopancreatic ampulla). Its sphincter the sphincter of Oddi, enables the regulation of bile flow. Anatomy The bile duct is some 6–8 cm long, and normally up to 8 mm in diameter. Its proximal supraduodenal part is situated within the free edge of the lesser omentum. Its middle retroduodenal part is oriented inferiorly and right-ward, and is situated posterior to the first part of the duodenum, and anterior to the inferior vena cava. Its distal paraduodenal part is oriented still more right-ward, is accommodated by a groove upon (sometimes a channel within) the posterior aspect of the head of the pancreas, and is situated anterior to the right renal vein. The bile duct terminates by uniting with the pancreatic duct (at an angle of about 60°) t ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Murphy's Sign
In medicine, Murphy's sign (also known as Sweeney’s sign) is a maneuver during a physical examination as part of the abdominal examination. It is useful for differentiating pain in the right upper quadrant. Typically, it is positive in cholecystitis, but negative in choledocholithiasis, pyelonephritis, and ascending cholangitis. During physical examination Classically, Murphy's sign is tested for during an abdominal examination in supine position; it is performed by asking the patient to breathe out and then gently placing the hand below the costal margin on the right side at the mid- clavicular line (the approximate location of the gallbladder). The patient is then instructed to breathe in. Normally, during inspiration, the abdominal contents are pushed downward as the diaphragm moves down (and lungs expand). If the patient stops breathing in (as the gallbladder is tender and, in moving downward, comes in contact with the examiner's fingers) and winces with a "catch" in br ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Ascending Cholangitis
Ascending cholangitis, also known as acute cholangitis or simply cholangitis, is inflammation of the bile duct, usually caused by bacteria ascending from Ampulla of Vater, its junction with the duodenum (first part of the small intestine). It tends to occur if the bile duct is already partially obstructed by gallstones. Cholangitis can be life-threatening, and is regarded as a medical emergency. Characteristic symptoms include jaundice, yellow discoloration of the skin or whites of the eyes, fever, abdominal pain, and in severe cases, hypotension, low blood pressure and mental confusion, confusion. Initial treatment is with intravenous fluids and antibiotics, but there is often an underlying problem (such as gallstones or Stenosis, narrowing in the bile duct) for which further tests and treatments may be necessary, usually in the form of endoscopy to relieve obstruction of the bile duct. The word is from Greek ''chol''-, bile + ''ang''-, vessel + -''itis'', inflammation. Signs an ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Pancreatic Duct
The pancreatic duct or duct of Wirsung (also, the major pancreatic duct due to the existence of an accessory pancreatic duct) is a duct joining the pancreas to the common bile duct. This supplies it with pancreatic juice from the exocrine pancreas, which aids in digestion. Structure The pancreatic duct joins the common bile duct just prior to the ampulla of Vater, after which both ducts perforate the medial side of the second portion of the duodenum at the major duodenal papilla. There are many anatomical variants reported, but these are quite rare. Accessory pancreatic duct Most people have just one pancreatic duct. However, some have an additional accessory pancreatic duct, also called the Duct of Santorini. An accessory pancreatic duct can be functional or non-functional. It may open separately into the second part of the duodenum,Moore KL, Dalley AF. 2006. Clinically Oriented Anatomy. 5th Ed. Lippincott Williams & Wilkins. p 287.1. Mchonde GJ, Gesase AP. Termination pat ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Lithiasis
A calculus (: calculi), often called a stone, is a concretion of material, usually mineral salts, that forms in an organ or duct of the body. Formation of calculi is known as lithiasis (). Stones can cause a number of medical conditions. Some common principles (below) apply to stones at any location, but for specifics see the particular stone type in question. Calculi are not to be confused with gastroliths, which are ingested rather than grown endogenously. Types thumbnail, Human gallstones, all removed from one patient. Grid scale 1 mm. * Calculi in the inner ear are called otoliths * Calculi in the urinary system are called urinary calculi and include kidney stones (also called renal calculi or nephroliths) and bladder stones (also called vesical calculi or cystoliths). They can have any of several compositions, including mixed. Principal compositions include oxalate and urate. * Calculi in the prostate are called prostatic calculi. * Calculi in the mammary gland a ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Acute Pancreatitis
Acute pancreatitis (AP) is a sudden inflammation of the pancreas. Causes include a gallstone impacted in the common bile duct or the pancreatic duct, heavy alcohol use, systemic disease, trauma, elevated calcium levels, hypertriglyceridemia (with triglycerides usually being very elevated, over 1000 mg/dL), certain medications, hereditary causes and, in children, mumps. Acute pancreatitis may be a single event, it may be recurrent, or it may progress to chronic pancreatitis and/or pancreatic failure (the term pancreatic dysfunction includes cases of acute or chronic pancreatitis where the pancreas is measurably damaged, even if it has not failed). In all cases of acute pancreatitis, early intravenous fluid hydration and early enteral (nutrition delivered to the gut, either by mouth or via a feeding tube) feeding are associated with lower mortality and complications. Mild cases are usually successfully treated with conservative measures such as hospitalization with intrav ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Fluoroscopy
Fluoroscopy (), informally referred to as "fluoro", is an imaging technique that uses X-rays to obtain real-time moving images of the interior of an object. In its primary application of medical imaging, a fluoroscope () allows a surgeon to see the internal anatomy, structure and physiology, function of a patient, so that the pumping action of the heart or the motion of swallowing, for example, can be watched. This is useful for both medical diagnosis, diagnosis and therapy and occurs in general radiology, interventional radiology, and image-guided surgery. In its simplest form, a fluoroscope consists of an X-ray generator, X-ray source and a fluorescence, fluorescent screen, between which a patient is placed. However, since the 1950s most fluoroscopes have included X-ray image intensifiers and cameras as well, to improve the image's visibility and make it available on a remote display screen. For many decades, fluoroscopy tended to produce live pictures that were not recorded, bu ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Abdominal Ultrasonography
Abdominal ultrasonography (also called abdominal ultrasound imaging or abdominal sonography) is a form of medical ultrasonography (medical application of ultrasound technology) to visualise abdominal anatomical structures. It uses transmission and reflection of ultrasound waves to visualise internal organs through the abdominal wall (with the help of gel, which helps transmission of the sound waves). For this reason, the procedure is also called a transabdominal ultrasound, in contrast to endoscopic ultrasound, the latter combining ultrasound with endoscopy through visualize internal structures from within hollow organs. Abdominal ultrasound examinations are performed by gastroenterologists or other specialists in internal medicine, radiologists, or sonographers trained for this procedure. Medical uses Abdominal ultrasound can be used to diagnose abnormalities in various internal organs, such as the kidneys, liver, gallbladder, pancreas, spleen and abdominal aorta. If Doppler ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Conjugated Bilirubin
Bilirubin (BR) (adopted from German, originally bili—bile—plus ruber—red—from Latin) is a red-orange compound that occurs in the normcomponent of the straw-yellow color in urine. Another breakdown product, stercobilin, causes the brown color of feces. Although bilirubin is usually found in animals rather than plants, at least one plant species, '' Strelitzia nicolai'', is known to contain the pigment. Structure Bilirubin consists of an open-chain tetrapyrrole. It is formed by oxidative cleavage of a porphyrin in heme, which affords biliverdin. Biliverdin is reduced to bilirubin. After conjugation with glucuronic acid, bilirubin is water-soluble and can be excreted. Bilirubin is structurally similar to the pigment phycobilin used by certain algae to capture light energy, and to the pigment phytochrome used by plants to sense light. All of these contain an open chain of four pyrrolic rings. Like these other pigments, some of the double-bonds in bilirubin isomerize wh ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
