Cholecystitis vs Cholelithiasis vs Cholangitis vs Choledocolithiasis

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In this lecture on Gastroenterology, we will be discussing the medical condition known as Choledocholithiasis. We will cover the causes of this condition and its management, as well as the clinical features that may be observed. • ▬ 📃 Choledocholithiasis ▬▬▬▬▬▬▬▬▬▬ • Choledocholithiasis is a medical condition in which gallstones or solid deposits that form in the gallbladder migrate to the common bile duct, causing obstruction of the bile flow from the liver to the small intestine. • ▬ 📜 Choledocholithiasis Etiology ▬▬▬▬▬▬▬▬▬▬ • The common causes of choledocholithiasis include: • 👉 Gallstones • When the gallstones formed in the gallbladder migrate into the common bile duct, it can lead to choledocholithiasis. • 👉 Bile duct strictures • Narrowing of the bile duct due to scarring or inflammation can lead to blockage of the bile duct, resulting in choledocholithiasis. • 👉 Tumors • Cancerous or noncancerous growths in the bile duct can cause blockage and result in choledocholithiasis. • ▬ 📃 Choledocholithiasis Clinical features ▬▬▬▬▬▬▬▬▬▬ • The clinical features of choledocholithiasis include: • 🟠 Abdominal pain: The pain can be sharp or dull and is usually located in the right upper quadrant of the abdomen. The pain may radiate to the back, shoulder, or chest. • 🟠 Jaundice: The blockage of the bile duct can cause a buildup of bilirubin (a yellow pigment) in the blood, leading to yellowing of the skin and whites of the eyes. • 🟠 Nausea and vomiting: The buildup of bile in the stomach can lead to nausea and vomiting. • 🟠 Fever and chills: Infection can develop in the blocked bile duct, leading to fever and chills. • 🟠 Clay-colored stools: The absence of bile in the stool can cause the stools to be light-colored or clay-colored. • 🟠 Itching: The buildup of bilirubin in the skin can cause itching. • ▬ 📜 Management of Choledocholithiasis ▬▬▬▬▬▬▬▬▬▬ • The management of choledocholithiasis depends on the severity of the symptoms and the extent of the obstruction. Treatment options include: • 👉 Observation • In some cases, choledocholithiasis may not cause any symptoms or complications, and observation may be recommended. • 👉 Endoscopic retrograde cholangiopancreatography (ERCP) • ERCP is a procedure that uses an endoscope (a thin, flexible tube with a camera) to remove gallstones from the common bile duct. • 👉 Laparoscopic common bile duct exploration (LCBDE) • LCBDE is a surgical procedure that involves making small incisions in the abdomen to remove gallstones from the common bile duct. • 👉 Open common bile duct exploration (OCBDE) • OCBDE is a surgical procedure that involves making a large incision in the abdomen to remove gallstones from the common bile duct. • 👉 Medications • In some cases, medications may be prescribed to manage the symptoms of choledocholithiasis, such as painkillers, anti-nausea medications, and antibiotics to treat infections. • ▬ 📃 Indications for Choledochotomy ▬▬▬▬▬▬▬▬▬▬ • Choledochotomy is a surgical procedure performed when the stones are too large or too numerous to be removed through less invasive methods like ERCP. It is also performed in cases where there is a high risk of complications with non-surgical treatments. • ▬ 📜 Types of Choledochotomy ▬▬▬▬▬▬▬▬▬▬ • The two main types of choledochotomy are open and laparoscopic. In open choledochotomy, the surgeon makes an incision in the abdomen to access the common bile duct and remove the stones. In laparoscopic choledochotomy, small incisions are made in the abdomen, and a laparoscope and surgical instruments are used to remove the stones. • The choice of treatment will depend on the severity of the symptoms, the size and number of the gallstones, and the presence of any underlying medical conditions. It is important to consult with a healthcare professional to determine the most appropriate course of treatment for your individual case. • ▬ 🎬 5500+ sqadia.com Medical Videos ▬▬▬▬▬▬▬▬▬▬ • 👩🏻‍⚕️ Medical students online education 24/7/365. • 💡 Medical learning made easy. • 💪 Study Hard, Dream Big. • #Choledocholithiasis #liverpathology #gallbladder #gallbladderstones #gallbladdersurgery #gallbladderstone #gallbladderremoval

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