gall bladder disease dr suleiman jastaniah,frcs (ed),facs,associted prof.umm-alqura university
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GALL BLADDER DISEASE Dr Suleiman Jastaniah,FRCS (Ed),FACS,Associted Prof.Umm-Alqura university. ANATOMY :. - PowerPoint PPT PresentationTRANSCRIPT
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GALL BLADDER DISEASE
Dr Suleiman Jastaniah,FRCS (Ed),FACS,Associted Prof.Umm-
Alqura university.
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ANATOMY:
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PHYSIOLOGY : -Concentrate bile by absorption of water and sodium. -CCK-------Gall.b.emptying. -Vagal stimulation.
DIAGNOSIS : *Plain Abdominal X-Ray. *Oral cholecystography : >Radio-opaque dye >It is +ve if it shows : a. Filling defect b.Non functioning G.B
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*U/S*CT SCAN
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GALL STONE : >Common problem all over the world . >Mixed. >Cholestrol. >Pigmented.
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CLINICAL MANIFISTATIONS :.GALLBLADDER STONE : 1.Asymptomatic. 2.Biliary Colic. 3.A.Cholecystitis> *Gangrene. *Perforation. *Empyema. 4.Ch.Cholecystitis.
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5.Mucocele. 6.Intestinal obstruction. Gallstone Ileus. 7.Carcinoma.
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Common Bile Duct Stones :
>Obstructive Jaundice.
>A.Cholangitis.
>Acute Pancreatitis.
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MANAGEMENT : 1.Open Cholecystectomy.
2.Laproscopic Cholecystectomy.
3.Cholecystostomy—ill patient.
*In Acute Cholecystitis.
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C.B.D. STONE : -Primary (Denovo) -Secondary (common ).*Diagnosis : *L.F.T *PT,APPT. *U/S. *ERCP. *MRCP.>HOW do you prepare obstructive jaundice
patient?
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MANAGEMENT OF C.B.D.STONES : -ERCP -Exploration of C.B.D. - Biliary enteric anastomasis. -Retained Stones : *Extraction through T-tube. *Percutanously via transhepatic route. *Dissolution by solvent. *ESWL. *Surgery.
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COMPLICATIONS OF CHOLECYSTOCTOMY:
1.Bleeding.
2.C.B.D. injury.
3.Stricture.
4.Postcholecystectomy syndrome.
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COMPLICATIONS ASSOCIATED WITH OBSTUCTIVE JAUNDICE :1.Cholengitis.2.Disorders of Clotting Factors.3.Renal Failure.4.Liver Failure.5.Fluid and electrolyte disorders.
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Char cot's triad :
-Fever.-Jaundice.-Rt.upper quadrant pain.*Reynolds Pentad -Septic shock -Mental status changes
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