Hepatobiliary System

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Hepatobiliary System

• Liver
• Gallbladder
• Bile ducts
• Pancreas

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Physiology and Function Liver

• The most important function of the liver is the
  production of bile. This plays a major role in
  the metabolism of carbohydrates, fats and
  proteins.

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Physiology and Function Gallbladder

• Bile is manufactured in the liver and stored in
  the gallbladder. When food, particularly fat is
  present in the duodenum, a hormone known as
  cholecystokinin is released into the blood stream
  which triggers the gallbladder to contract and
  release bile aiding in the breakdown of that fat.

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Pathology and FunctionPancreas

• It has both endocrine and exocrine functions.
• The endocrine functions produce hormones insulin
  and glucagon.
• The exocrine functions include the secretion of
  enzymes that digest carbohydrates, fat and
  proteins.

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Special Radiographic procedures for the Liver

• KUB
• CT
• MRI
• Ultrasound
• Nuclear Medicine

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Special Radiographic Procedures for the
Gallbladder and Bile Ducts

• CT
• Ultrasound (method of choice)
• Nuclear medicine
• Intravenous Cholangiography (IVC)
• Operative Cholangiography
• T-tube Cholangiography
• Percutaneous Tran hepatic Cholangiography (PTC)
• Oral Cholecystogram (OCG)

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Special Radiographic Procedures for the Pancreas

• CT
• Ultrasound
• Endoscopic Retrograde Cholangiographic
  Pancreatography (ERCP)

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PathologyLiver

• Cirrhosis normal tissue is destroyed and
  replaced by scar tissue, which diminishes the
  ability of the organ to function properly.

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Radiographic findings

• Abdominal films reveal hepatomegaly, ascites, and
  air-fluid levels
• CT scans reveal hepatic nodules and lesions

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Hepatitis inflammation of the liver cells

• Deficiency hepatitis associated with alcoholism
• Toxic hepatitis associated with drug use
• Viral hepatitis
• A infectious hepatitis
• B serum hepatitis
• C
• D- delta hepatitis
• E

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Radiographic findings

• Hepatomegaly on abdominal radiographs

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Jaundice

• A yellowish cast to the skin and sclera of the
  eyes that is the result of excess bilirubin in
  the blood

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Liver Inflammatory Processes

• Jaundice (icterus)
• 2 Types
• a. Medical (non-obstructive)
• 1. hemolytic
• 2. hepatic
• b. Surgical (obstructive)

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Types of Jaundice

• Medical (non-obstructive)
• Hemolytic Jaundice
• Hepatic Jaundice
• Surgical (obstructive)

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Neoplasms of Liver

• Hepatomas any tumor of the liver. Most often
  malignant
• Cholangiocarcinoma cancer that arises form the
  biliary ductule cells of the liver

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Congenital Anomalies of the Gallbladder and Bile
Ducts

• Duplication more than one gallbladder
• Bilobed the gallbladder is divided into two
  chambers by an internal septum
• Hourglass the body of the gallbladder is
  narrowed in the middle
• Phryian cap the fundus of the gallbladder folds
  over the body
• Choledochal cyst a weakness in the wall of the
  bile duct allows a cystic structure to form.

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Gallbladder and Bile Ducts

• Congenital Anomalies
• Duplication
• Bilobed
• Hourglass
• Phyrgian cap
• Choledochal cysts
• A. Septated gallbladder,
• B. Bilobed
• C F. Double gallbladder.

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Inflammatory Process

• Hydrops when the cystic duct is blocked and the
  gallbladder increases in size
• Cholangitis an inflammation of the bile ducts
• Cholecystitis an inflammation of the
  gallbladder
• Cholelithiasis stones in the gallbladder

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Radiographic Findings of Cholelithiasis

• If the stones are radiolucent, they will appear
  on any abdominal radiograph.
• If stones are not radiolucent, they should be
  visualized with ultrasound or nuclear medicine
  studies

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Gallbladder and Bile DuctsInflammations

• Cholelithiasis
• Gangrenous Gallbladder

• Hydrops
• Cholangitis
• Cholecystitis
• Porcelain Gallbladder

A collection of Gallstones
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Gallstones
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Neoplasms of the gallbladder

• Carcinoma most often caused by an irritation
  from chronic gall stones.

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Congenital Process of the Pancreas

• Cystic fibrosis the pancreatic ducts fill with
  thick mucus, which leads to dilations of the
  ducts and fibrosis of the pancreas

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Inflammatory Processes of the Pancreas

• Acute pancreatitis most are caused by alcohol
  abuse or by gallstones irritation
• Chronic pancreatitis relapsing pancreatitis
  that causes progressive fibrosis and destruction
  of the pancreatic cells.

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Neoplasms of the Pancreas

• Islet cell tumors benign tumors of the pancreas
• Carcinoma cancer of the pancreas
• Adenocarcinoma cancer that arises form the
  ductal system

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Radiographic Findings of Adenocarcinoma

• Abnormalities of the duodenum caused by a tumor
  in the pancreatic head are most common.