gall bladder disease dr suleiman jastaniah,frcs (ed),facs,associted prof.umm-alqura university
DESCRIPTION
GALL BLADDER DISEASE Dr Suleiman Jastaniah,FRCS (Ed),FACS,Associted Prof.Umm-Alqura university. ANATOMY :. - PowerPoint PPT PresentationTRANSCRIPT
GALL BLADDER DISEASE
Dr Suleiman Jastaniah,FRCS (Ed),FACS,Associted Prof.Umm-
Alqura university.
ANATOMY:
PHYSIOLOGY : -Concentrate bile by absorption of water and sodium. -CCK-------Gall.b.emptying. -Vagal stimulation.
DIAGNOSIS : *Plain Abdominal X-Ray. *Oral cholecystography : >Radio-opaque dye >It is +ve if it shows : a. Filling defect b.Non functioning G.B
*U/S*CT SCAN
GALL STONE : >Common problem all over the world . >Mixed. >Cholestrol. >Pigmented.
CLINICAL MANIFISTATIONS :.GALLBLADDER STONE : 1.Asymptomatic. 2.Biliary Colic. 3.A.Cholecystitis> *Gangrene. *Perforation. *Empyema. 4.Ch.Cholecystitis.
5.Mucocele. 6.Intestinal obstruction. Gallstone Ileus. 7.Carcinoma.
Common Bile Duct Stones :
>Obstructive Jaundice.
>A.Cholangitis.
>Acute Pancreatitis.
MANAGEMENT : 1.Open Cholecystectomy.
2.Laproscopic Cholecystectomy.
3.Cholecystostomy—ill patient.
*In Acute Cholecystitis.
C.B.D. STONE : -Primary (Denovo) -Secondary (common ).*Diagnosis : *L.F.T *PT,APPT. *U/S. *ERCP. *MRCP.>HOW do you prepare obstructive jaundice
patient?
MANAGEMENT OF C.B.D.STONES : -ERCP -Exploration of C.B.D. - Biliary enteric anastomasis. -Retained Stones : *Extraction through T-tube. *Percutanously via transhepatic route. *Dissolution by solvent. *ESWL. *Surgery.
COMPLICATIONS OF CHOLECYSTOCTOMY:
1.Bleeding.
2.C.B.D. injury.
3.Stricture.
4.Postcholecystectomy syndrome.
COMPLICATIONS ASSOCIATED WITH OBSTUCTIVE JAUNDICE :1.Cholengitis.2.Disorders of Clotting Factors.3.Renal Failure.4.Liver Failure.5.Fluid and electrolyte disorders.
Char cot's triad :
-Fever.-Jaundice.-Rt.upper quadrant pain.*Reynolds Pentad -Septic shock -Mental status changes