Gallbladder ✅


Blood supply from Rt hepatic AR-->cystic artery .

Venus drange from cystic vein to--->
Rt portal vein

Nerve supply from Lt vagus N--> Ant gastric N --> cystic nerve .

Lymphatic drange: Lund --> portal hepatic LN ---> celiac LN.

Calot's triangle.

Type of stones

Mirizzi's syndrome

🚫In acute cholecystitis if there is no jaundice there is no need for MRCP/ERCP, ✔️✔️✔️

Dx of Acc  ➡️cbc /US if us inconclusive  use HIDA SCan
For exculde jaundice Act ➡️LFT.

🛑 Murphy's sign : positive If pt suddenly stop inspiration while you are palpating on the site of Gallbladder.

🛑Murphy's sign specific for acute cholecytitis.

⭕️ Complications of acute cholecystitis :

¹ empyema
² emphesematose
³ Obs jaundice
⁴ fistula
⁵ abscess
⁶ perforation

Note : No small intestinal obstruction complications in acute cholecystitis.

ERCP🔥

Q/ A 35-year-old man presents with right upper quadrant pain, fever,
jaundice, and shaking chills. Ultrasound of the abdomen demonstrates
gallstones, normal gallbladder wall thickness, and common bile duct of
1.0 cm. His total bilirubin is 5. In addition to IV fluids and antibiotics,
which of the following is the most appropriate next step in this patient’s
management?

Q/ 30 y old lady presented with H/o  of acute pain in right hypochondrium which is radiating to angle of the right scapula she vomited few times as well the D/D diagnosis of the lady 's symptoms includes all of the followings Except: