USMLE forum
Step 1
Step 2 CK
Step 2 CS
Matching & Residency
Step 3
  <<   < *  Step 1   *  >   >>  

* CBD obstruction
  b_cereus - 02/11/19 08:21
  what is the source of infection? behind the obstruction from where bacteria popped in? stasis i agree , thickens the bile but bacteria?  
Report Abuse


* Re:CBD obstruction
  cardio69 - 02/11/19 18:02

Once the flow of bile is blocked/obstruction, bacteria can find their way UP the pipe & colonize mc mix enteric organisms/E.coli, Klebsiella… (especially gallbladder fail to elicit clinical pic/ “silent”) the biliary system, RT? So, w/bladder to being wash away and they can migrate -> blockage & infect stagnant bile & their surrounding neighbor tissue, RT?
Moreover, you understand the bile pipe under “HIGH P” from what? Obstruction😊 -> cause the spaces btw the cells lining the duct to stretch, RT😊 which then permit bacteria & bile direct can flyaway -> access to the bloodstream.

Crystal clear

Now Q 4 u;
On unconjugated bilirubin is norm a minute component of bile? YES, now you tell me “what you think INC/release?” that led to more hydrolyze bilirubin glucuronides especially when infection of tract/biliary.
Report Abuse

* Re:CBD obstruction
  b_cereus - 02/12/19 06:03
  hello cardio69 how are you?
Thank you for reply.
But i still don't get how does bacteria enter region behind the obstruction ? from gut back(duodenum) upwards into CBD before obstruction , i agree but into billiary Tract, i am still thinking.

for your q ; UCB will be increased b/c Bacteria has enzyme to convert CB back into UCB.

Report Abuse

* Re:CBD obstruction
  cardio69 - 02/12/19 19:38
  I think that what your Q as at 1st “behind the obstruction from where bacteria popped in” that would exact explanation I just dissected for you above.

Now for your new q, in pat with acute cholangitis that 1ry caused by bacteria for exp, bacteria typically ascend from 1st part of duodenum/hematogenous spread from the portal vein. Also, you understand the bacteria populate the GI tract. However, # are smaller in duodenum & jejunum than you home on the ileum, colon & rectum, clearing that for you. You understand sphincter of Oddi can pomp/reflux those bacteria (pass through the Oddi even in small #) from that we all got from the presence of foreign body/food/or let on say endoscopic sphincterotomy, biliary stent… or endoscopic those bacteria can colorize about obstruction ( i.e stone/stent..)

The term “ascending cholangitis” comes from the migration of bacteria from the duodenum -> CBD But, rarely, translocation of bacteria from the portal vein -> bile duct can happen.

RT on Q, the name of it beta/glucuronidases.

Report Abuse

* Re:CBD obstruction
  b_cereus - 02/13/19 04:52
  Aahaa! Got it.

Thank you.
Report Abuse

* Re:CBD obstruction
  cardio69 - 02/13/19 20:54
  Most welcome (:  
Report Abuse

          Page 1 of 1          

[<<First]   [<Prev]  ... Message ...  [Next >]   [Last >>]

Logon to post a new Message/Reply




Step 1 Step 2 CK Step 2 CS Matching & Residency Step 3 Classifieds
LoginUSMLE LinksHome