Chapter 11: The Gallbladder and the Biliary System
adenomyomatosis
small polypoid projections from the gallbladder wall
ampulla of Vater
small opening in the duodenum in which the pancreatic and common bile duct enter to release secretions
bilirubin
yellow pigment in bile formed by the breakdown of red blood cells
cholangitis
inflammation of the bile duct
cholecystectomy
removal of the gallbladder
cholecystitis
inflammation of the gallbladder; may be acute or chronic
cholecystokinin
hormone secreted into the blood by the mucosa of the upper small intestine; stimulates contraction of the gallbladder and pancreatic secretion of enzymes
choledochal cyst
cystic growth of the common duct that may cause obstruction
choledocholithiasis
stones in the bile duct
cholelithiasis
gallstones in the gallbladder
cholesterolosis
variant of adenomyomatosis; cholesterol polyps; also called cholesterosis
common bile duct
extends from the point where the common hepatic duct meets the cystic duct; drains into the duodenum after it joins with the main pancreatic duct
common duct
refers to common bile or hepatic ducts when the cystic duct is not seen
common hepatic duct
bile duct system that drains the liver into the common bile duct
cystic duct
connects the gallbladder to the common hepatic duct
gallbladder (GB)
storage pouch for bile
Hartmann’s pouch
small part of the gallbladder that lies near the cystic duct where stones may collect
Heister’s valves
tiny valves found within the cystic duct
hydrops
massive enlargement of the gallbladder
jaundice
excessive bilirubin accumulation that causes yellow pigmentation of the skin; first seen in the whites of the eyes
junctional fold
small septum within the gallbladder, usually arising from the posterior wall
Klatskin’s tumor
cancer at the bifurcation of the hepatic ducts; may cause asymmetric obstruction of the biliary tree
Murphy’s sign
positive sign implies exquisite tenderness over the area of the gallbladder upon palpation
pancreatic duct
travels horizontally through the pancreas to join the common bile duct at the ampulla of Vater
Phrygian cap
gallbladder variant in which part of the fundus is bent back on itself
polyps of the gallbladder
small, well-defined soft tissue projection from the gallbladder wall
porcelain gallbladder
calcification of the gallbladder wall
porta hepatis
central area of the liver where the portal vein, common duct, and hepatic artery enter
sludge
low-level echoes found along the posterior margin of the gallbladder; move with change in position
sphincter of Oddi
small muscle that guards the ampulla of Vater
wall echo shadow (WES) sign
sonographic pattern found when the gallbladder is packed with stones
Name the layers of the GB
serosal
subserosal
muscular
mucosal
What is the least common variant of the gallbladder?
agenesis
What GB variant is associated with cystic fibrosis?
hypoplasia
What does bile consist of?
bile salt
cholesterol
amino acids
conjugated hormones
fat digestion
What is the most common GB variant?
Junctional fold
What causes bile to flow?
cholecystokinin causes contraction of GB
bile flows if ductal pressure is lower than hepatic secretory pressure
What does increased WBC indicate?
accute cholecystitis
chronic cholecystitis
injury to bile duct
What does increased bilirubin indicate?
sub accute cholecystitis
choledocholithiasis
injury to bile duct
GB carcinoma
internal biliary fistula
What does increased indirect bilirubin indicate?
pre or hepatic obstruction
What does increased direct bilirubin indicate?
post hepatic obstruction
What does increased alkaline phosphatase (ALP) indicate?
biliary obstruction
What does increased aspartate aminotansferase (AST) indicate?
injured liver
skeleton
heart
What does increased alanine aminotansferase (ALT) indicate?
injured liver
stays elevated long
phrygian cap
hartmann's pouch
junctional fold
septated