Porcelain Gallbladder
- Associated with Chronic Cholecystitis or Cholelithiasis
- Increased Risk of Gallbladder Adenocarcinoma
- RUQ Pain
- Usually Asymptomatic
- Often Found Incidentally
- Confirm with CT or Ultrasound
- Prophylactic Cholecystectomy
Acute Cholangitis Characteristics and Clinical Features
- Biliary Tract Infection
- Biliary Tract Obstruction
- Charcot's Triad
- Fever
- Jaundice
- Abdominal Pain
- Reynold's Pentad
- + Hypotension
- + Altered Mental Status
Ascending Cholangitis Diagnosis and Treatment
- ERCP
- CT Scan
- Ultrasound
- Biliary Duct Dilation and/or Stones
- Hyperbilirubinemia
- Elevated Alkaline Phosphatase
- Elevated GGT
- Broad Spectrum Antibiotics
- Biliary Drainage
Acute Pancreatitis Disease
- Autodigestion of Pancreas by Pancreatic Enzymes
- Epigastric Abdominal Pain Radiating to Back
- Anorexia
- Nausea
- Increased Amylase and Lipase
- Disseminated Intravascular Coagulation (DIC)
- Infection
- Hypocalcemia
- Systemic Inflammatory Response Syndrome (SIRS)
- Acute Respiratory Distress Syndrome (ARDS)
- Pancreatic Pseudocyst
- Hemorrhage
Acute Pancreatitis Assessment
- Heavy Alcohol Use and Gallstones
- Abdominal Pain
- Nausea/Vomiting/Anorexia
- Abdominal Rigidity/Guarding
- Decreased or Absent Bowel Sounds
- Hypotension and Tachycardia
- Jaundice
- Increased White Blood Cells
Acute Pancreatitis Causes
- "GET SMASHHED" Mnemonic
- Gallstones
- (Ethanol) Alcohol
- Trauma
- Steroids
- Mumps
- Autoimmune
- Scorpion Sting
- Hypercalcemia
- Hypertriglyceridemia > 1000
- ERCP
- Drugs
Acute Pancreatitis Interventions
- NPO with NG Tube to Suction
- Pain Management
- Albumin
- Lactated Ringers Solution
- Proton Pump Inhibitor (PPI)
- Antibiotics
- Surgery
- Nutrition
Acute Abdomen Differential Diagnosis: Upper Quadrants
- Cholecystitis
- Biliary Colic
- Cholangitis
- Perforated Duodenal Ulcer
- Acute Hepatitis
- Splenic Rupture
- IBS (Splenic Flexure Syndrome)
Acute Abdomen Differential Diagnosis: Midepigastrium and Diffuse
- Peptic Ulcer Disease
- Pancreatitis
- Aortic Dissection
- Myocardial Infarction
- Peritonitis
- Hemorrhage or Perforation
- Bowel Obstruction
- Strangulation
- Acute Hepatitis