The document discusses various topics related to biliary anatomy and gallbladder disease:
1) It describes common gallbladder conditions like cholecystitis, gallstones, porcelain gallbladder, and Mirizzi syndrome.
2) Imaging findings for evaluating these conditions are provided, including ultrasound, CT, and ERCP findings.
3) Treatment options are summarized for various gallbladder diseases and complications.
4. Biliary lithiasis 最佳影像診斷線索 : Echogenic foci with posterior acoustic shadowing (10% stones: No acoustic shadow) in US Discrete & (movable) lower signal (density) filling defects within bile ducts in MRC and ERCP Opaque stones (20%) in plain radiography
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7. Gallbladder completely filled with calculi ~ Calculi are molded ( 鑄造 ) by the wall of the gall bladder : the acoustic shadow posterior to the Calculi that do not change with positional change
15. Milk of calcium bile Calcium carbonate precipitate within gall bladder lumen (calcium milk) 最佳影像診斷線索 : Identification of calcified liquid within gallbladder (echogenic fluid similar to sludges but with acoustic shadowing) Incidental finding: asymptom or RUQ pain Etiology: GB stasis ~ Ca++ carbonate in bile, thickness of GB wall
20. Porcelain GB Calcification of gallbladder wall 最佳影像診斷線索 : Rim of calcification in RUQ conforming to GB shape Usually asymptomatic ; old age Rish factor for gallbladder carcinoma Prophylactic cholecystectomy is current consensus recommendation
41. Chronic Cholecystitis Two appearance Small, contracted, sclerosed GB with/without stones (fasting state) Same imaging appearance as acute cholecystitis but without Murphy sign (terderness)
43. Mirizzi syndrome Partial or complete obstruction of common hepatic duct (CHD) due to gallstone impacted in cystic duct or gall bladder neck 最佳影像診斷線索 : Impacted cystic duct stone on US with proximal dilatation of intraheptic ducts
64. Pathological No.: 962230 Date of Arrival: 2007/8/7 Date of Report: 2007/8/8 Pathological diagnosis: Gall bladder, cholecystectomy ----- ----- Chronic cholecystitis with acute exacerbation and cholelithiasis Gross: The specimen consists of an opened gall bladder, measuring 9.2 x 4.5 x 3 cm in size. It is enlarged. The wall is thickened and measuring up to 0.5 cm in thickness. The mucosal folds are absent. There are several pieces of black stone in the lumen. Representative parts are embedded in one block. Microscopy: The sections show a picture of edema, neutrophilic infiltration, congestion, hemorrhage, abscess formation, fibrosis and focal chronic inflammatory cell infiltration in the lamina propria, muscular layer and perimuscular layer. Rokitansky-Aschoff sinuses are present.