Disorders Of Hepatic, Bilary, And Pancreatic Function Notes
This is a sample of our (approximately) 3 page long Disorders Of Hepatic, Bilary, And Pancreatic Function notes, which we sell as part of the Gastrointestinal (GI) System Notes collection, a 1st (70-80%) package written at Bristol University in 2012 that contains (approximately) 57 pages of notes across 19 different documents.
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Lecture 22 Disorders of hepatic, bilary and pancreatic function
Bilary disease o Gallstones
• Cholesterol/mixed 90-95%
• Pigment (break down haemoglobin) 5-10%
• Cholesterol (crystallised cholesterol)
• Mixed (crystallised cholesterol & cholesterol with bile pigment)
• Pigment (calcium bilirubinate)
• Cholesterol/mixed o Many theories o Relative saturation of cholesterol, phospholipid, bile salts
• Pigment o Deconjugation of bilirubin mono- and di-glucuronides
• Cholesterol/mixed o Female>male; pregnancy; OCP o Diabetes o Animal fat rich diet, rapid weight loss/gain
• Pigment o Haemolysis; Cirrhosis; Ileal resection
• Silent- incidence 80%
• Bilary colic o Impaction of stone in GB neck or cystic duct o "Spasm" of contractions in GB wall as it tries to squeeze out stone o Usually lasts hours and radiates to back
• Acute cholecystitis o Prolonged impaction of stone in GB neck or cystic duct o Inflammation of gallbladder o Overgrowth of bacteria leading to infection
• Migration into common bile duct/bilary tree= jaundice/infection (COMMON)
• Migration through wall of GB into GI tract
• Murphy's sign (unable to breathe when RUQ palpated because of pain) o Bilary obstruction
• Serum (haemoglobin>haem>biliverdin>bilirubin)
• Hepatocyte (bilirubin> bilirubin glucuronides)
• Bile>Intestine (deconjugated/reduced>oxidised)
• Anatomical o Intraluminal- stones
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