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32 Cards in this Set
- Front
- Back
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What is the measurement required for diagnosis of hps
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muscle width greater than 3 mm or pyloric canal lenght greater than 15
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What is the ddx of pyloric stenosis
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pylorospasm
doudenal feeding tubes eosinophilic gastroenteritis antral polyps idiopatthic or prostagladin induced foveolar hyperplasia |
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What condition can progress to HPS
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prolonged pylorospasm and this must be monitored
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What are some inflammatory causes of diffuse gallbladder wall thickening
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cholecystitis, hepatitis, pancreatitis, perforated DU, diverticulitis
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What is a major cause of GB wall thickening (greater than 3mm)
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contracted gb after eating fatty meal
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Can GB wall thickening happen in patient that has hepatitis that hasnt progressed to cirrhosis
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yes
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What are 4 risk factors for gallstones
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female, obesity, diabetes, pregnancy
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What percent of patients with gallstones have complicatins
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20%
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What is an imaging pitfall for diagnosising cholelithiasis
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an airbubble within the doudenum
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How do you differentiate a airbubble in the doudenum from a true gall stone
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air will cause dirty shadowing.
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What is considered a distended gallbladder
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greater than 4cm x 10cm
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What percent of people that have cholecystitis have gallstones
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90-95%
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How is doppler useful in diagnosing cholelithiasis
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there will be a hyperemic wal
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What is the ppv of patients with gallstones and a postive murphys sign for having cholecystitis
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92%
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If a pt has emphysematous cholecytitis what should else should you look for in the liver
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pneumobilia
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Does a pt with gangrenous cholecytitis always have a murphys sign
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no, 2/3 will not
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What is the US findings in a patient with gangrenous cholecystitis
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bands of non-layering intraluminal echogenic material, irregular wall, murphy absent 2/3
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If someone has fluid in the abdomen (looks like ascites) and ruq pain
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gallbladder perforation.
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What are patients at risk for acalcoulus cholecystitis
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major trauma/surgery, sepsis, tpn, diabetes, hiv
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Do pts with acalculous cholecystitis have a murphys sign
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no
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What is the acroynm for risk of malignancy of gallbladder polyps
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six s's
size greater than 1 cm sixty or greater single sessile stones rapid size increase |
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What is the differential for gallbladder polyps
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cholesterol polyps (50%)
inflammatory (10%) adenoma (5%) cholangiocarcinoma mets |
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When is a biliary duct considered dilated
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if it is greater than 6-7 mm til age 60
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How do you determine if the right and left hepatic ducts are dilated
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if they are greater than 2mm or more than 40% the diameter of adjacent PV
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What percent of cholangiocarcinoma is adenocarcinoma
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90%
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What are the common locations of cholangiocarcinoma
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klatskin (hilar) 60%
distal 30% intrahepatic 10% |
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What is the appearance of cholangiocarcinoma on US
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heterogeneous, hypovascular
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What is the MC casue of pneumobilia
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biliary intervention (ercp, sphincterotomy)
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How is portal venous gas differentiated from pneumobilia
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portal venous gas is peripheral branching and ill defined
pneumobilia is centrally and more obvous on US |
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If a patient has portal venous gas what is the next step
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order a ct
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What is the most common cause of portal venous gas
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MC-bowel ischemia or bowel infart
but could be obstruction, pancreatitis, diverticulitis, abscess |
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What patients is portal venous gas more common in
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diabetics
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