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12 Cards in this Set
- Front
- Back
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What is the clinical presentation of ascending cholangitis? |
Charcot's triad: fever, abdominal pain and jaundice |
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Imaging appearance of ascending cholangitis? |
CT shows hyperenhancement and thickening of the bile duct walls US may see some debris in the biliary system |
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Tx for ascending cholangitis? |
Conservative with abx and fluids usually. May need endoscopic biliary intervention if doesn't respond. |
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What is primary sclerosing cholangitis? |
idiopathic inflammation and destruction of bile ducts. |
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What disease is PSC most commonly associated with? % of PSC with this disease? |
Ulcerative colitis (75% with PSC have UC; although onlyl 4% with UC have PSC). |
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What is the imaging appearance of PSC? |
- Beaded irregular common bile duct and intrahepatic bile ducts. |
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What other disease does PSC also look similar to based on the imaging findings? What's the difference? |
HIV cholangiopathy HIV cholangiopathy more often has papillary stenosis. |
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Long-term consequences of PSC? (3) |
- Cirrhosis - Cholangiocarcinoma - Recurrent biliary infections *x-sectional imaging better at looking for these complications than ERCP |
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What is primary biliary cirrhosis, how does it differ from PSC, and who does it affect? |
Inflammation and destruction of smaller (only intrahepatic) bile ducts than compared with PSC. Middle aged women. (presents with pruritis) *can lead to cirrhosis like PSC |
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AIDS (HIV) cholangiopathy is similar in appearance to primary sclerosing cholangitis. What is the presumed etiology of HIV cholangiopathy? |
Biliary infections: CMV and Crytosporidium --> RUQ pain, fever, and elevated LFT's. *remember it leads to papillary stenosis aka stenosis of the Sphincter of Oddi (in contrast to PSC). |
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What is the cause of recurrent pyogenic cholangitis? |
Clonorchis sinensis (liver fluke) --> pigment stone formation, biliary stasis and cholangitis. Indiginous to SE Asia (aka Oriental cholangiohepatitis) *inceased risk cholangiocarcinoma |
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What is the imaging appearance of recurrent pyogenic cholangitis? (3) |
Triad: - Pneumobilia - Lamellated bile duct filling defects - Intra and extrahepatic bile duct dilation and strictures. |
