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Gastrointestinal & Hepatic-Biliary Systems. Chapter 5 Part II. Objectives. Discuss the common illnesses/ conditions involving the hepatic/biliary organs signs & symptoms etiology management . Hepatic-Biliary Diseases. Hepatitis Gallstones & Gallbladder disease

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objectives
Objectives
  • Discuss the common illnesses/ conditions involving the hepatic/biliary organs
    • signs & symptoms
    • etiology
    • management
hepatic biliary diseases
Hepatic-Biliary Diseases
  • Hepatitis
  • Gallstones & Gallbladder disease
  • Acute & chronic pancreatitis
hepatic biliary diseases4
Hepatic-Biliary Diseases
  • Hepatitis
    • A
      • contracted orally (usually through food)
      • persons infected with A usually recover fully
    • B, C, & D
      • contracted through contact with body fluids
      • B & C cause the most damage to the liver
hepatic biliary diseases5
Hepatic-Biliary Diseases
  • Hepatitis
    • Signs & Symptoms
      • Jaundice
      • Fatigue
      • Loss of appetite
      • Dark urine
      • Light stools
  • Diarrhea
  • Fever
  • Joint pain
  • Pain in RUQ
  • Enlarged liver
hepatic biliary diseases6
Hepatic-Biliary Diseases
  • Hepatitis
    • Management
      • No specific medical treatment
      • Sometimes antiviral meds are used
      • Prevention of spread of disease
        • Hand-washing
        • Proper protection (gloves, etc.)
        • Vaccination
hepatic biliary diseases7
Hepatic-Biliary Diseases
  • Gallstones & gallbladder disease
    • Cholelithiasis – formation of gallstones within the gallbladder or bile ducts
      • more common among women than men
      • gallstones may be present without producing symptoms
      • symptoms begin when stones obstruct abiliary duct
hepatic biliary diseases8
Hepatic-Biliary Diseases
  • Gallstones & gallbladder disease
    • Cholelithiasis – etiology
      • obesity
      • high calorie diets
      • oral contraceptives
      • multiple pregnancies
      • increasing age
hepatic biliary diseases9
Hepatic-Biliary Diseases
  • Gallstones & gallbladder disease
    • Cholelithiasis – signs & symptoms
      • acute onset of pain in URQ
      • radiating pain to shoulder and back (shoulder blade)
      • nausea, vomiting
      • flatulence, belching, & heartburn
      • tend to follow large meals or fatty foods
hepatic biliary diseases10
Hepatic-Biliary Diseases
  • Gallstones & gallbladder disease
    • Cholelithiasis – diagnostic procedures
      • diagnostic ultrasound
hepatic biliary diseases11
Hepatic-Biliary Diseases
  • Gallstones & gallbladder disease
    • Cholelithiasis – management
      • laparoscopic cholecystectomy to remove gallbladder IF symptoms don’t subside on their own
hepatic biliary diseases12
Hepatic-Biliary Diseases
  • Gallstones & gallbladder disease
    • Acute cholecystitis
      • Severe inflammation of the interior wall of the gallbladder
hepatic biliary diseases13
Hepatic-Biliary Diseases
  • Gallstones & gallbladder disease
    • Acute cholecystitis – etiology
      • obstruction of bile ducts by gallstones
      • pressure from accumulated bile in the gallbladder
      • chemical changes in the bile
      • secondary infection from multiplying bacteria
hepatic biliary diseases14
Hepatic-Biliary Diseases
  • Gallstones & gallbladder disease
    • Acute cholecystitis – signs & symptoms
      • gradual onset of pain in URQ localized over gallbladder
      • nausea, vomiting
      • low grade fever
hepatic biliary diseases15
Hepatic-Biliary Diseases
  • Gallstones & gallbladder disease
    • Acute cholecystitis – diagnostic procedures
      • Blood tests
      • Diagnostic ultrasound
      • Abdominal x-ray
hepatic biliary diseases16
Hepatic-Biliary Diseases
  • Gallstones & gallbladder disease
    • Acute cholecystitis – management
      • dietary changes
      • medication to reduce inflammation and/or spasm of gallbladder
hepatic biliary diseases17
Hepatic-Biliary Diseases
  • Acute Pancreatitis
    • severe, life-threatening inflammation of the pancreas
    • pancreatic enzymes begin digesting pancreatic tissue producing:
      • swelling
      • tissue necrosis
      • hemorrhage
hepatic biliary diseases18
Hepatic-Biliary Diseases
  • Acute Pancreatitis – etiology
    • alcoholism
    • gallstones
    • trauma to abdomen
    • viral infections
    • drug reations
    • pancreatic cancer
    • complications from a duodenal ulcer
hepatic biliary diseases19
Hepatic-Biliary Diseases
  • Acute Pancreatitis – signs & symptoms
    • sudden onset of severe, persistent abdominal pain
      • centered over epigastric region
      • may radiate pain toward back
    • abdominal tenderness
    • abdominal distension (not always present)
    • persistent vomiting
    • alterations in vitals
      • fever
      • tachycardia
      • rapid, shallow respirations
      • decrease in blood pressure
hepatic biliary diseases20
Hepatic-Biliary Diseases
  • Acute Pancreatitis – diagnostic procedures
    • blood tests
      • elevated level of amylase enzyme
    • diagnostic ultrasound
    • abdominal CT scan
hepatic biliary diseases21
Hepatic-Biliary Diseases
  • Acute Pancreatitis – management
    • Aimed at reducing symptoms
      • maintain circulation & fluid volume through IV
      • decrease pain
      • decrease pancreatic secretions
hepatic biliary diseases22
Hepatic-Biliary Diseases
  • Chronic Pancreatitis
    • Slow, progressive destruction of pancreatic tissue accompanied by:
      • inflammation
      • fibrosis
      • dilation of pancreatic ducts
hepatic biliary diseases23
Hepatic-Biliary Diseases
  • Chronic Pancreatitis – etiology
    • Most commonly associated with alcoholism
hepatic biliary diseases24
Hepatic-Biliary Diseases
  • Chronic Pancreatitis – signs & symptoms
    • severe, persistent, dull abdominal pain
    • pain that worsens after a meal
    • weight loss
hepatic biliary diseases25
Hepatic-Biliary Diseases
  • Pancreatic cancer – signs & symptoms
    • severe, persistent, dull abdominal pain
    • pain in midback
    • pain that worsens after a meal
    • weight loss
    • jaundice
    • weakness
    • fatigue
    • diarrhea
    • nausea
    • vomiting
hepatic biliary diseases26
Hepatic-Biliary Diseases
  • Pancreatic cancer – management
    • Palliative – aimed at making person comfortable by managing pain
      • most pancreatic cancers are diagnosed after they have metastasized to the lungs, liver, and bones
    • 80-85% of cases are advanced at first diagnosis