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30 Cards in this Set
- Front
- Back
What is considered diffuse GB wall thickening
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wall thickening that is greater than 3 mm
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What is the DDX of diffuse GB wall thickening
4 |
edematous states
inflammatory states AIDS Neoplasm Misc |
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What are some causes of edematous states which result in Gall bladder wall thickening
4 |
CHF, Renal failure, cirrhosis, hypoalbunemia
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What are some inflammatory states that cause GB wall thickening
5 |
cholecystitis, hepatitis, pancreatitis, perforated DU, diverticulitis
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What are the major neoplastic causes of diffuse GB wall thickening
2 |
adenoca, METS
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What are 2 misc causes of GB wall thickening
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varices, and adenomyomatosis
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During what phase of digestion would the GB be expected to be thickened
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post prandial
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What causes diffuse gallbladder wall thickening in HIV
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AIDS cholangiopathy
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Does aids cholangiopathy have increased flow in the thickened GB
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yes
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Can diffuse GB wall thickening happen in hepatitis without cirrhosis
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yes
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What are 4 risk factors for cholelithiasis
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female, obese, DM, pregnancy
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What are 4 complications of cholelithiasis
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acute cholecystitis
GB gangrene GB perf Gallstone ileus |
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What are 3 classic characteristics of Gallstones
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echogenic
posterior acoustic shadowing mobile (mostly) |
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What is a common pitfall and often mistaken for cholelithiasis
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a gas bubble in the doudenum
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What helps to differentiate a gas
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it will have dirty shadowing
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What is the measurement of a distended GB
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>4cm
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What are 6 clues that a pt has cholecystitis
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GB wall thickeness > 3mm
distended GB >4cm gallstones or impacted stones at the neck pericholecystic fluid postive murphies hyperemic GB wall |
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Is there increased flow to the GB wall in cholecystis
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yes
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What is the PPV of a pt with a positive muphys sign and gallstones
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92%
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What are 3 potential complications of cholecystitis
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gangrene, perforation, emphysematous cholecystitis
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What does the GB look like in Gangrene
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bands of nonlayering intraluminal echogenic material , irregular wall, murphies absent in 2/3 of cases
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What % of pt with GB gangrene have a murphies sign
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only 1/3
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What are 2 major clues that a pt has emphsematous cholecystitis
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gas in the lumen and wall of GB
pneumobilia |
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When does acalculous cholecystitis occur
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in the absence of stones;
critically ill pts or pts on TPN or HIV |
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Do pts with acalculous cholecystitis have a positive murphies sign
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no, (like gangraneous cholecystitis)
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What are 4 causes of focal GB wall thickenening
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adenomyomatosis
polyps Varices GB carcinoma |
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What mimics focal GB wall thickening
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tumefactive sludge, adherent stones
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How do you differentiate a GB polyp from sludge
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it will have flow
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What are 50% of GB wall polyps
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cholesterol polyps
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What are the 6 S's of increased risk of malignancy for GB polyps
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size greater than 1cm
greater than 60 Single Sessile GallStones Rapid Size increase |