Category Archives: Hepatobiliary Surgery

Main Clinical Manifestations of Biliary Tract Diseases

Biliary tract diseases encompass a spectrum of disorders affecting the gallbladder, cystic duct, and extra- or intra-hepatic bile ducts. Symptoms arise from obstruction, inflammation, infection, or neoplastic change, and often overlap among entities such as cholelithiasis, cholecystitis, cholangitis, and cholangiocarcinoma. Recognition of characteristic patterns guides timely imaging and intervention. Biliary colicParoxysmal, post-prandial pain located in the epigastrium or right upper quadrant, radiating to the inter-scapular region or right shoulder, peaking over ≥30 min and resolving spontaneously within 6 h. Nausea and vomitingVagal stimulation and gastric compression produce repeated retching that may transiently relieve pain. Fluctuating or progressive jaundiceConjugated hyper-bilirubinaemia manifests... Learn more

Related articles：

  1. Main Clinical Manifestations of Biliary Tract Tumours
  2. Main Clinical Manifestations of Congenital Biliary Malformations
  3. Main Clinical Manifestations of Hepatic Hydatid Disease
  4. Main Clinical Manifestations of Hilar Cholangiocarcinoma
  5. Main Clinical Manifestations of Cholangitis
  6. Main Clinical Manifestations of Chronic Cholecystitis

Main Clinical Manifestations of Bile-Duct Stones

Choledocholithiasis denotes the presence of calculi within the extra- or intrahepatic bile ducts. Symptoms arise when a stone obstructs flow, triggers inflammation, or provokes infection. The presentation ranges from silent imaging findings to life-threatening sepsis. Biliary colicEpigastric or right-upper-quadrant pain begins 30–60 min post-prandially, peaks for ≥30 min, and radiates to the inter-scapular region or right shoulder. Movement does not relieve the discomfort, and analgesics are often required. Nausea and vomitingGastric stasis and vagal reflexes produce repeated retching that may transiently lessen pain. Fluctuating jaundiceIntermittent elevation of conjugated bilirubin produces scleral icterus, dark urine, and clay-coloured stools that wax and... Learn more

Related articles：

  1. Main Clinical Manifestations of Extrahepatic Bile-Duct Stones
  2. How is bile-duct stone disease treated?
  3. Main Clinical Manifestations of Cholangitis
  4. Main Clinical Manifestations of Hepatic Hydatid Disease
  5. Main Clinical Manifestations of Biliary Tract Diseases
  6. Main Clinical Manifestations of Chronic Cholecystitis

Main Clinical Manifestations of Cholangitis

Cholangitis denotes acute bacterial infection within the biliary tree, most commonly precipitated by obstruction from stones, strictures, or neoplasia. The spectrum ranges from mild ductal inflammation to life-threatening sepsis. Recognition of its cardinal features guides urgent biliary decompression and antimicrobial therapy. Complication warningsPersistent fever despite antibiotics, uncontrolled hypotension, or new-onset renal dysfunction suggests progressive sepsis and requires urgent endoscopic or percutaneous biliary drainage. Charcot triadIntermittent high spiking fever with rigors, constant right-upper-quadrant pain, and conjugated hyper-bilirubinaemia constitute the classical presentation seen in ~70 % of patients with incomplete or partial obstruction. Reynolds pentadAddition of hypotension (systolic BP < 90 mmHg)... Learn more

Related articles：

  1. Main Clinical Manifestations of Bile-Duct Stones
  2. Main Clinical Manifestations of Hepatic Hydatid Disease
  3. Main Clinical Manifestations of Extrahepatic Bile-Duct Stones
  4. Main Clinical Manifestations of Biliary Tract Diseases
  5. Main Clinical Manifestations of Congenital Biliary Malformations
  6. Main Clinical Manifestations of Chronic Cholecystitis

Main Clinical Manifestations of Hilar Cholangiocarcinoma

Hilar cholangiocarcinoma (Klatskin tumour) arises at or near the confluence of the right and left hepatic ducts. Because the lesion obstructs the central bile ducts early, symptoms are usually biliary and appear while the tumour is still relatively small. Painless jaundiceConjugated hyper-bilirubinaemia develops insidiously, producing progressive yellowing of skin and sclera, dark urine and clay-coloured stools; pruritus is often intense and may precede visible icterus. Right-upper-quadrant discomfortA dull, non-colicky ache or sensation of fullness is common; pain is usually mild and does not parallel the degree of jaundice. Cholangitis episodesIntermittent fever with rigors, right-sided tenderness and elevated C-reactive protein occur... Learn more

Related articles：

  1. Main Clinical Manifestations of Hepatic Hydatid Disease
  2. Main Clinical Manifestations of Biliary Tract Diseases
  3. Main Clinical Manifestations of Congenital Biliary Malformations
  4. Main Clinical Manifestations of Biliary Tract Tumours
  5. What Are the Symptoms of Cholangiocarcinoma?
  6. What Are the Symptoms of Intrahepatic Cholangiocarcinoma?

Main Clinical Manifestations of Hepatic Ascites

Ascites is the pathological accumulation of fluid within the peritoneal cavity secondary to portal hypertension, hypoalbuminaemia and sodium retention. In patients with chronic liver disease it marks the transition from compensated to decompensated cirrhosis. The severity ranges from mild, detected only by imaging, to gross, producing marked physical and metabolic disturbances. Metabolic disturbancesHyponatraemia, muscle cramps and hypervolaemic dilutional anaemia reflect advanced renal sodium retention and impaired free-water clearance. Progressive abdominal distensionPainless increase in girth is usually the first complaint; patients note tight clothing, difficulty bending forward, and a sensation of heaviness in the flanks. Shifting dullness and fluid thrillOn percussion,... Learn more

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  1. Main Clinical Manifestations of Hepatic Hydatid Disease
  2. Main Clinical Manifestations of Hepatic Abscess
  3. Main Clinical Manifestations of Hepatic Rupture
  4. Main Clinical Manifestations of Extrahepatic Bile-Duct Stones
  5. Main Clinical Manifestations of Acute Cholecystitis
  6. Main Clinical Manifestations of Chronic Cholecystitis