BIOM2071 Lecture Notes - Lecture 24: Combined Oral Contraceptive Pill, Common Bile Duct, Gallstone
Document Summary
Function: store bile produced by liver and release into small intestine during digestion. Location: under liver (neutralises acids and breaks down fats: fat in digested food enters small intestine and releases cholecystokinin triggers gallbladder to release bile via common bile duct. 1st trimester: biliary cholesterol concentration in gallbladder bile and progressive increase in biliary sludge (precursor of gallstones: biliary sludge: thick cholesterol output (lies at base of gallbladder) Risk factors: age, female, pregnancy, combined oral contraceptive pill, obesity, spinal cord injury. Diagnosis: incidental at antenatal uss; transabdominal uss (rapid, non-invasive, low cost, accurate) or duodenal intubation (collection/examination of bile samples by polarising light microscopy) Management: support, analgesic, surgery (if recurrent/unrelenting pain/symptoms cholecystectomy safe after 2nd trimester) Resolution: often spontaneous disappearance of biliary sludge and gallstone dissolution. Bile cannot flow from liver to duodenum. Obstructive: mechanical blockage in duct system (gallstone or malignancy) or metabolic (disturbances in bile formation genetic defect or acquired due to medication)
