Biliary Disorders: Review

00:01 So now that we've gone through those several conditions, let's now summarize everything.

00:07 So review that cholelithiasis is the presence of a stone in the gallbladder.

00:12 Patients may present with biliary colic that self-resolves.

00:16 The labs will often be normal.

00:18 It can be detected by ultrasound.

00:20 And the treatment is with an elective cholecystectomy if they're symptomatic.

00:26 Patients may also have cholecystitis which presents with right upper quadrant pain and fever.

00:31 They may have a high white count and an elevation in their alkaline phosphatase and bilirubin.

00:38 They may.. You will detect this diagnosis based on ultrasound.

00:42 And treatment consists of IV antibiotics and removal of the gallbladder during that same admission.

00:48 The next condition is choledocholithiasis.

00:51 Recall that this is a gallstone impacted in the common bile duct.

00:55 So patients may present with biliary colic and they may have jaundice depending on whether the duct is completely obstructed.

01:02 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.

01:11 Diagnosis is made by MRCP or endoscopic ultrasound and treatment is with an ERCP to remove the stone.

01:20 The last condition we talked about was cholangitis.

01:23 This is when you have an ascending infection into the gallbladder from an impacted common bile duct stone.

01:30 So you may present with right upper quadrant pain and jaundice.

01:35 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.

01:48 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.

01:59 Thank you very much for your attention.