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