THE BILIARY TRACT.

Slides:



Advertisements
Similar presentations
Gallbladder Disease Candice W. Laney Spring 2014.
Advertisements

Dr. Gehan Mohamed Dr. Abdelaty Shawky
GALLBLADDER Fe A. Bartolome, MD, FPASMAP Department of Pathology
GB & BILIARY TREE Begashaw M (MD).
Gall Bladder disease in Children Laredo Medical Center March 29 th 2011 Francisco Cervantes, MD Khalid Ghazy,MD.
Gastrointestinal & Hepatic- Biliary Systems Chapter 5 Part II.
CLINICAL CHEMISTRY-2 (MLT 302) LIVER FUNCTION AND THE BILIARY TRACT LECTURE FIVE Dr. Essam H. Aljiffri.
Gallbladder and Pancreas Gallbladder  Anatomy and physiology  Calculous biliary disease  Benign acalculous biliary disease  Malignant biliary disease.
Biliary Tree Dr Bina Ravi Consultant and Associate Professor Surgery.
GALLSTONES Tanja Čujić Mentor: A. Žmegač Horvat. Anatomy of gallbladder and extrahepatic biliary tree Bile Helps the body digest fats Made in the liver.
Bernard M. Jaffe, M.D. Professor of Surgery, Emeritus
Pathogenesis of diseases of the gallbladder and biliary tract John J O’Leary.
PATHOLOGY AND PATHOGENESIS OF CHOLECYSTITIS
Gall stone disease.
Chapter 12 Liver, Gallbladder, and Pancreas Diseases and Disorders
CHOLECYSTITIS SODIENYE HALLIDAY M.D.. OUTLINE WHAT IS CHOLECYSTITIS. BRIEF DESCRIPTION OF THE GALLBLADDER, ITS FUNCTION AND ANATOMY. CAUSES OF CHOLECYSTITIS.
GALLSTONES By: Anika Khan Role #1030.
GALL BLADDER. Cholelithiasis (Gallstones) Gallstones afflict 10-20% of adult populations in northern hemisphere Western countries. Adult prevalence rates.
J AUNDICE Mohammed Al- Rajeh & Shreef Al- Qahtani.
Gallbladder and Duct Disorders Cholelithiasis and Related Disorders.
DR. FIRAS OBEIDAT, MD GBS, pathogenesis and complications.
Gallstone Disease.
THE GALLBLADDER AND THE BILIARY TREE BY MICHAEL BRILLANTES, MD, FPCS, FPSGS.
GALL BLADDER DISEASE Dr Suleiman Jastaniah,FRCS (Ed),FACS,Associted Prof.Umm- Alqura university.
Biliary Tract Congenital Anomalies Disorders of gallbladder Acute cholecystitis Chronic cholecystitis Disorders of Extra hepatic bile ducts Choledocholithi.
Biliary System Heartland Society of Gastroenterology Nurses and Associates Mary Ganley RN CGRN BSHA.
PATHOLOGY AND PATHOGENESIS OF CHOLECYSTITIS. Disorders of the Gallbladder CHOLELITHIASIS (GALLSTONES) Majority of gallstones (>80%) are "silent," and.
DR.HAMAD ALQAHTANI Associate Professor Consultant Hepatobiliary Surgeon.
Diagnostic studies Blood Tests Imaging Modalities Reference: Schwartz’s Principles of Surgery 8 th Edition.
Cholecystitis & Cholelithiasis
Behzad Nakhaei, M.D., FICS Fellowship in HepatoBiliary Surgery Mc Gill University RUQ & Upper Abdomen Inflammation & Infection GallBladder & Biliary System.
Histopathology and cytology (MLHC-201) Faculty of allied medical sciences.
PANCREATIC CANCER.
Gastrointestinal & Hepatic-Biliary Systems
Pathophysiology Complications Diagnosis Treatment
Hepatobiliary disease Mazen Hassanain. Gall stones / Pathophysiology Bile facilitates the absorption of lipids and fat-soluble vitamins Bilirubin, bile.
BENIGN BILIARY TRACT DISEASES. DEVELOPMENT AND FUNCTION FROM FOREGUT ABOUT 3 /52 0F GESTATION BLOOD SUPPLY -- COELIAC AND SUPR. MESENTERIC VESSELS FUNCTION.
Faisal Al-Saif MBBS, FRCSC, ABS. - Acute Pancreatitis - Chronic Pancreatitis - Pancreatic Tumors - Pancreas Transplant.
Gall bladder.
Gall bladder and Biliary disease Dr.Umit Akyuz Gastroenterology Department Yeditepe University,Istanbul.
Department of Pathology
Acalculous Cholecystitis Characteristic of acalculous disease: Acute gallbladder inflammation complicating severe underlying illness Ultrasound, CT, or.
ACUTE CHOLECYSTITIS Koray Topgül, MD, Prof. Department of General Surgery.
Disorders of gall bladder
담도질환 Biliary stone disease Infectious/inflammatory disease Tumor
PATHOLOGY AND PATHOGENESIS OF CHOLECYSTITIS. Pathology and pathogegenesis of cholecystitis Compare the various types of gallstones, how they are formed,
Dr Amit Gupta Associate Professor Dept of Surgery
Obstructive jaundice Etiology :
Radiology of hepatobiliary diseases
Gastric carcinoma.
Gall Bladder Disease Cara Campbell.
Gallstone Disease.
DISORDERS OF GALLBLADDER AND EXTRAHEPATIC BILIARY TRACT
Made by: Kalyk Zhansaya Group: GMF Checed by: Zhalikenova R.S
SON 2111 Abdominal Sonography 1 Lecture 6 The Biliary Tree and Gallbladder Part 1 Holdorf.
PATHOLOGY AND PATHOGENESIS OF CHOLECYSTITIS
Digestive pathology 2.
Gall Stones Cholelithiasis.
HEPATIC NODULES AND TUMORS
THE LIVER.
Coffs Harbour Divisional Training
Liver diseases III.
Care of Patients with Problems of the Biliary System and Pancreas
Dr. Samina Qamar FCPS Histopathology
Gastrointestinal Pathology 3
HEPATOBILIARY AND PANCREATIC DISORDERS
PATHOLOGY AND PATHOGENESIS OF CHOLECYSTITIS
Pathology and Pathogenesis of Gallstones & Cholecystitis
Presentation transcript:

THE BILIARY TRACT

Gall Bladder

a storage organ for bile, with a capacity of 50 mL in adults .a storage organ for bile, with a capacity of 50 mL in adults .histology -mucosa -fibro-muscular layer -sub-serosal layer -peritoneal covering .cystic duct joins common hepatic duct> common bile duct courses head of pancreas>duodenum through Ampulla of Vater

CONGENITAL ANOMALIES .Agenesis .Duplicated .Bi-lobed .Aberrant location .Folded fundus

CHOLELITHIASIS. afflicts 10%-20% of adults CHOLELITHIASIS .afflicts 10%-20% of adults .types -cholesterol-containing stones, (80%) -bilirubin-containing stones, (20%) .risk factors -cholesterol stones .old age .female sex hormones .obesity & metabolic syndrome .rapid weight reduction .gallbladder stasis .inborn errors of bile acid metabolism .hyperlipidemia syndromes

-pigment stones. chronic hemolytic syndromes. biliary infection -pigment stones .chronic hemolytic syndromes .biliary infection .gastro-intestinal disorders (Crohn disease, ileal resection or bypass, cystic fibrosis)

pathogenesis -cholesterol stones .pathogenesis -cholesterol stones .super-saturation of bile with bilirubin & cholesterol -pigment stones .disorders associated with elevated levels of unconjugated bilirubin in bile -hemolytic syndromes -severe ileal dysfunction or bypass -bacterial contamination of biliary tree

morphology -cholesterol stones .morphology -cholesterol stones .pure-pale yellow, round to ovoid, (radiolucent) .mixed (calcium carbonate, phosphates, & bilirubin)-gray-white to black, (radio- opaque in 10%-20%) -pigment stones .black-sterile bile (radio-opaque in 50%- 75%) .brown-infected bile (all radiolucent)

Gall bladder, cholesterol stones

Gall bladder, pigment stones

.clinical features -silent -biliary colic -complication in gall bladder (empyema, perforation, fistulas, cholecystitis, carcinoma) -cholangitis & cholestasis -pancreatitis -intestinal obstruction

CHOLECYSTITIS .almost always occurs in association with gall stones .types -acute -chronic -active chronic

Acute Cholecystitis .calculous cholecystitis (obstruction of bladder neck or cystic duct) .acalculous cholecystitis (severely ill patients) -post-operative state -severe trauma -severe burns -multi-system organ failure -sepsis -prolonged intra-venous line -post-partum state

pathogenesis -calculous (chemical inflammation) -acalculous (ischemia) .pathogenesis -calculous (chemical inflammation) -acalculous (ischemia) .morphology -enlarged hemorrhagic gallbladder -lumen is filled with turbid bile that may contain pus & fibrin -empyema -gangrene

.clinical features -abdominal pain at right upper quadrant or epigastric region -most patients have no jaundice -in calculous cholecystitis, the attack may be sudden -in acalculous cholecystitis, symptoms are more insidious

Chronic Cholecystitis Chronic Cholecystitis .follows bouts of acute cholecystitis, or occurs de novo .gall stones are present in 90% of cases .pathogenesis -super-saturation of bile .morphology -gross, thickened wall, lumen contains clear, mucoid bile & usually stones -histology, inflammation -hydrops of gallbladder

Chronic cholecystitis

Chronic cholecystitis, Rokitansky-Aschoff sinus

.clinical features -recurrent attacks of abdominal pain at epigastric or right upper quadrant -nausea, vomiting, & intolerance for fatty foods .complications -bacterial infection>cholangitis -gallbladder perforation>local abscess -gallbladder rupture>peritonitis -biliary-enteric fistula -aggravation of a pre-existing medical illness -porcelain gall bladder>cancer

Extra-Hepatic Bile Ducts

CHOLEDOCHOLITHIASIS .stones either arise within gallbladder, or formed in ducts .clinical features -asymptomatic -obstruction>cholangitis -pancreatitis -hepatic abscess -secondary biliary cirrhosis -acute calculous cholecystitis

BILIARY ATRESIA .complete or partial obstruction of lumen of extra-hepatic biliary tree within first 3 months of life .presents as neonatal cholestasis .pathogenesis -fetal form, associated with other anomalies -perinatal form, normal biliary tree is destroyed after birth, due to .viral infection, or .genetic predisposition

Tumors Of Gall Bladder

BENIGN TUMORS AND TUMOR-LIKE LESIONS. Adenoma. Inflammatory polyp BENIGN TUMORS AND TUMOR-LIKE LESIONS .Adenoma .Inflammatory polyp .Adenomyosis

CARCINOMA OF THE GALLBLADDER. slightly more common in females CARCINOMA OF THE GALLBLADDER .slightly more common in females .most frequently in the 7th decade of life .only rarely is surgically resectable .mean 5-year survival rate is about 1% .predisposing factors -stones -infection .morphology -grossly (infiltrative, exophytic) -microscopically (adenocarcinoma) .clinically, rarely detected preoperatively

Gall bladder, adenocarcinoma

Gall bladder, adenocarcinoma