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gall-bladder - Biliary Tract Biliary Tract Congenital...

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Biliary Tract Biliary Tract Congenital Anomalies Congenital Anomalies Disorders of gallbladder Disorders of gallbladder Disorders of Extra hepatic bile ducts Disorders of Extra hepatic bile ducts Tumors Tumors Acute cholecystitis Acute cholecystitis Chronic cholecystitis Chronic cholecystitis Choledocholithiasis Choledocholithiasis Ascending cholangitis Ascending cholangitis Biliary atresia Choledochal cysts Choledochal cysts
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MC congenital anomalies = abnormal variants of the gallbladder MC= folded fundus ( Phrygian cap ) Others= congenitally absent, bilobed or aberrantly located gall bladder Most common congenital anomaly
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Cholelithiasis ( Gall Stones) 10 to 20% of adults in developed countries Two kinds of stones 1. Cholesterol Stones= crystalline cholesterol monohydrate , Risk factors Native American adult in industrialized country increased age (>40 yrs, Forty ) Females 2:1 estrogenic influences ( Fertile ) Clofibrate Obesity ( Fatty ) or rapid weight loss Gallbladder stasis, in spinal cord injury pregnancy Hypercholesterolemic syndromes
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1. Cholesterol Stones contd… Four conditions -necessary for cholesterol stone formation 1. supersaturated bile with cholesterol 2. gallbladder hypomotility promotes crystal nucleation 3. microprecipitates of calcium salts (inorganic or bilirubin salts) 4. Mucus hypersecretion in the gallbladder Morphology = Pale yellow and hard, ovoid, usually single, Often radiolucent Cholesterol stones arise exclusively in the gall bladder 2. Pigmented Stones= bilirubin calcium salts Risk factors Asian , Rural Chronic hemolytic syndromes Biliary tract infection (E. coli, Ascaris lumbricoides, liver fluke -Opisthorchis) Ileal disease (resection or bypass)
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