So now that we've gone through those several
conditions, let's now summarize everything.
So review that cholelithiasis is the
presence of a stone in the gallbladder.
Patients may present with
biliary colic that self-resolves.
The labs will often be normal.
It can be detected by ultrasound.
And the treatment is with an elective
cholecystectomy if they're symptomatic.
Patients may also have cholecystitis which
presents with right upper quadrant pain and fever.
They may have a high white count and an elevation
in their alkaline phosphatase and bilirubin.
They may.. You will detect this
diagnosis based on ultrasound.
And treatment consists of IV antibiotics and
removal of the gallbladder during that same admission.
The next condition is choledocholithiasis.
Recall that this is a gallstone
impacted in the common bile duct.
So patients may present with biliary
colic and they may have jaundice
depending on whether the
duct is completely obstructed.
Then on their labs, you may find an
elevated alkaline phosphatase and GGT,
a high bilirubin and you may have
transient elevations in their AST and ALT.
Diagnosis is made by MRCP
or endoscopic ultrasound
and treatment is with an
ERCP to remove the stone.
The last condition we
talked about was cholangitis.
This is when you have an ascending infection into the
gallbladder from an impacted common bile duct stone.
So you may present with right
upper quadrant pain and jaundice.
They tend to have more lab
abnormalities when compared to the others
so they have leukocytosis, elevated
alkaline phosphatase and GGT,
high bilirubin and may have
an elevation in the AST and ALT.
The diagnosis is made
again with MRCP or ultrasound
and treatment is with IV antibiotics and an ERCP
to remove the stone causing the obstruction.
Thank you very much for your attention.