Clinical Findings
Pain in this abdominal quadrant is the most common symptom of gallbladder disease.
What is the RUQ?
This sonographic sign shows a bright line followed by shadowing, representing a gallbladder filled with stones.
What is the WES Sign? (Acoustic Shadowing)
This classic mnemonic summarized as 'Female, Fat, Fertile, Forty, Fair' outlines the primary risk factors for developing this specific type of biliary stone.
What are cholesterol gallstones?
Porcelain gallbladder—a condition characterized by extensive calcium deposition within the muscular wall—is clinically significant because it drastically increases the lifetime risk of developing which malignancy?
What is Gallbladder Adenocarcinoma?
This chronic, progressive, obliterative fibrosis of intra- and extrahepatic bile ducts most classically presents in middle-aged males and is strongly associated with Ulcerative Colitis.
What is Primary Sclerosing Cholangitis?
When a patient experiences pain and respiratory arrest on transducer pressture over the gallbladder, this clinical sign is positive.
What is Murphy Sign?
This unique imaging finding, known as the 'Champagne sign' on plain film, ultrasound, or CT, is highly specific for which variant of gallbladder inflammation?
What is Emphysematous Cholecystitis?
Calcium salt deposit in a chronically inflamed gallbladder wall is known as this.
What is porcelain gallbladder?
Extrahepatic cholangiocarcinoma cases occurring at the convergence of the right and left hepatic ducts are commonly driven by mutations in which pair of genes?
What are P53 and KRAS mutations?
This rare congenital condition presents within the first 3 months of life and features a progressive, fibroinflammatory destruction that completely or partially obliterates the extrahepatic biliary tree.
What is Biliary Atresia?
Patient is positive for this sign if they have enlarged, nontender gallbladder and painless jaundice. (What disease is this sign generally associated with?)
What is Courvoisier sign? Often associated with cholangiocarcinoma, malignant cause of biliary obstruction, pancreatic carcinoma, sometimes porcelain gallbladder.
When assessing an adult patient with suspected gallbladder cancer, this specific threshold for gallbladder wall thickness on MRI/MRCP serves as a strong predictor of malignancy.
What is greater than 7.5 mm?
While surgical removal is the gold standard, medical management using oral gallstone dissolution therapy with UDCA is strictly limited to which specific patient criteria?
What radiolucent cholesterol stones <5mm diameter?
While intrahepatic cholangiocarcinoma has its highest global incidence in Southeast Asia and Thailand, it is uniquely driven on a cellular level by what pathophysiological mechanisms?
What is chronic stasis and bile acid toxicity activating ERK1/2, Akt and NF-KB pathways?
Chemical inflammation of the gallbladder wall during acute calculous cholecystitis is primarily initiated by the intraluminal release of which toxic compound?
What is lysolecithin?
This tumor marker—frequently tracked alongside Carcinoembryonic Antigen (CEA)—is commonly elevated in the serum of patients presenting with advanced Cholangiocarcinoma.
What is CA 19-9? It is an a sialylated Lewis blood group antigen useful for tracking hepatobiliary malignancies.
On magnetic resonance cholangiopancreatography (MRCP), this classic imaging pattern described as 'beading' is caused by alternating strictures and dilations of the bile ducts.
What is Primary Sclerosing Cholangitis (PSC)?
This rare, autoimmune destruction of small intra-hepatic bile ducts characteristically features antimitochondrial antibodies (AMAs) and predominantly targets middle-aged women.
What is Primary Biliary Cholangitis (PBC)?
This specific clinical entity occurs predominantly in critically ill ICU patients due to gallbladder stasis or global hypoperfusion, carrying a notoriously difficult diagnosis due to non-specific presentation elements.
What is Acalculous cholecystitis?
This specialized laboratory finding—specifically an elevated serum IgG4 level—is used clinically to rule out primary sclerosing cholangitis and establish which alternative diagnosis?
What is Secondary Sclerosing Cholangitis?
These liver enzyme lab findings (LFTs) are typical for cholestatic pattern.
What is elevated conjugated bilirubin, cholesterol, ALP and GGT?
This triple-imaging signature—consisting of pneumobilia, a mechanical small bowel obstruction, and an ectopic gallstone within the iliac fossa—is known by this diagnostic name.
What is Rigler's Triad? (associated with complication of acute cholecystitis - gallstone ileus)
This unique mechanical complication occurs when a large gallstone erodes through the gallbladder wall directly into the gastrointestinal tract, eventually impacting at the narrowest point of the small bowel.
What is Gallstone Ileus? (complication of acute cholecystitis)
Patient that present with this clinical triad (that can often progress to a pentad) is associated with what gallbladder disease? (Name & list the clinical triad and pentad)
What is ascending cholangitis? Charcot's triad include RUQ pain, fever, and jaundice; Reynold's pentad is triad + AMS and shock.
In neonates with advanced biliary atresia where a Roux-en-Y choledochojejunostomy is impossible, this specific surgical procedure is performed to create a hepatic portoenterostomy.
What is the Kasai procedure?