Term
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Definition
Inflammation of the gallbladder
Can be caused by stones or stem from hepatic/pancreatic problems |
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Term
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Definition
Gall stones
Results in obstruction of the ducts
Most common in overweight women of middle age
Pregnancy is the #1 risk factor |
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Term
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Definition
Bilirubin is produced by liver and is a byproduct of RBC destruction
Liver takes unconjugated bilirubin and conjugates it into bile
Bile promotes digestion of fat, fat-soluble vitamins, and cholesterol |
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Term
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Definition
RUQ pain
Rebound tenderness (Blumberg’s sign)
Can radiate to back/sternum/shoulder/between shoulder blades
Often mistaken for cardiac symptoms
Nausea/vomiting/pain post meals especially those high in fat
Belching
Flatulence
Abdominal fullness
With Chronic
Jaundice
Clay-colored stools
May indicate complete blockage
Dark urine
Steatorrhea |
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Term
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Definition
Increased direct (conjugated) and indirect (unconjugated) bilirubin with obstructive
WBC with left shift
Elevated alkaline phosphatase, AST (Aspartate aminotransferase), LDH (lactate dehydrogenase)
Pancreatic—amylase
US of GB
HIDA scan
Endoscopic retrograde cholangiopancreatography (ERCP)/can be used to treat too
UGI series to rule out GI problem
Hepatobiliary scan |
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Term
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Definition
Surgery
Usually outpatient laparoscopic cholecystectomy
Open cholecystectomy
Extracorpeal Shock Wave Lithotripsy (ESWL)
Meet criteria
No pancreatitis
No fever
Fewer than 4 stones
< 3 cm in diameter
Percutaneous transhepatic biliary catheter (decompression)
Choledocholithotomy (for temporary t-tube insertion until inflammation subsides)
Stone sample |
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Term
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Definition
ABC’s
Wound
Incisions
JP
T-Tube (care see next slide, normal 400ml/day)
NGT
Pain
Diet |
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Term
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Definition
Assess color of drainage, amount of output
Assess for tube kinking, pulling
Assess site for infection/skin breakdown, use sterile dressings while hospitalized
Position high Fowlers with t-tube to gravity
Clamping/unclamping regimen to assess readiness to remove tube
Resolution should include decrease in manifestations of cholecystitis |
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Term
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Definition
Drug therapy
Chendiol, Ursodiol
Opioids except for MS
Antispasmodic/anticholinergic such as Bentyl
Antiemetics such as Promethazine (Phenergan) or Trimethobenzamide (Tigan)
Bile sequesters such as cholestyramine (Questran)
Antihyperlipidemic agents
Diet therapy
May be NPO to start and have NGT
Decrease fat and volume |
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Term
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Definition
Pain
N/V
Fluid Volume Deficit
Altered Nutrition
Impaired Skin integrity r/t itching from bile salt accumulation and jaundice |
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Term
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Definition
Symptomology consistent with chronic cholecystitis, with hepatosplenomegaly
Treatments include surgery, radiation and chemotherapy
Surgery may include Whipple procedure
Removal of distal portion of the stomach, head of the pancreas, portions of the duodenum, common bile duct, and GB |
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