Coledocolitíase é a presença de cálculos no ducto colédoco. Esta condição causa icterícia e lesão às células do fígado, sendo uma emergência médica, necessitando de CPRE ou tratamento cirúrgico.
Índice
1Causa
2Complicações
3Diagnóstico
4Tratamento
Causa |
Enquanto as pedras podem frequentemente passar através do ducto colédoco em direção ao duodeno, algumas pedras podem ser muito grandes para passar através do ducto colédoco, causando uma obstrução.
Complicações |
Esta obstrução causa icterícia, elevação da fosfatase alcalina, aumento da bilirrubina conjugada no sangue e aumento do colesterol no sangue. Também pode causar pancreatite aguda e colangite ascendente.
Diagnóstico |
Imagem de duas pedras no ducto colédoco distal
Os médicos podem usar um exame de sangue de fosfatase alcalina, bilirrubina e colesterol para diagnosticar coledocolitíase.
Entretanto, um ultrassom demonstrando um ducto colédoco aumentado é o exame de escolha.
Tratamento |
O tratamento envolve a remoção dos cálculos, através de terapia cirúrgica ou endoscópica (CPRE). As cirurgias comumente realizadas envolvem a realização de papiloesfinteroplastias transduodenais, coledocotomias com drenagem biliar por dreno em T e derivações biliodigestivas. Tipicamente a vesícula biliar é removida para prevenção de futuras ocorrências de obstrução do ducto colédoco.
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Sistema digestivo - Gastroenterologia (K20-K93)
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