Transcript of GALL BLADDER DISEASE Dr Suleiman Jastaniah,FRCS (Ed),FACS,Associted Prof.Umm- Alqura university.
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- GALL BLADDER DISEASE Dr Suleiman Jastaniah,FRCS
(Ed),FACS,Associted Prof.Umm- Alqura university.
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- ANATOMY :
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- 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
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- * U/S *CT SCAN
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- GALL STONE : >Common problem all over the world. >Mixed.
>Cholestrol. >Pigmented. GALL STONE : >Common problem all
over the world. >Mixed. >Cholestrol. >Pigmented.
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- CLINICAL MANIFISTATIONS :.GALLBLADDER STONE : 1.Asymptomatic.
2.Biliary Colic. 3.A.Cholecystitis> *Gangrene. *Perforation.
*Empyema. 4.Ch.Cholecystitis.
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- 5.Mucocele. 6.Intestinal obstruction. Gallstone Ileus.
7.Carcinoma. 5.Mucocele. 6.Intestinal obstruction. Gallstone Ileus.
7.Carcinoma.
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- Common Bile Duct Stones : >Obstructive Jaundice.
>A.Cholangitis. >Acute Pancreatitis.
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- MANAGEMENT : 1.Open Cholecystectomy. 2.Laproscopic
Cholecystectomy. 3.Cholecystostomy ill patient. *In Acute
Cholecystitis.
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- 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?
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- 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.
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- COMPLICATIONS OF CHOLECYSTOCTOMY: 1.Bleeding. 2.C.B.D. injury.
3.Stricture. 4.Postcholecystectomy syndrome.
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- COMPLICATIONS ASSOCIATED WITH OBSTUCTIVE JAUNDICE :
1.Cholengitis. 2.Disorders of Clotting Factors. 3.Renal Failure.
4.Liver Failure. 5.Fluid and electrolyte disorders.
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- Char cot's triad : -Fever. -Jaundice. -Rt.upper quadrant pain.
*Reynolds Pentad -Septic shock -Mental status changes
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