Disorders of Biliary System, Cholecystitis, Gall stones.

1. Cognito ergo sum. Descartes I think, therefore I am…!

7. “ Thought is Free & Powerful” --William Shakespeare “Human mind is the most powerful weapon in the world…! - Osama bin laden…!

8. Pathology of Biliary Disorders Dr. Shashidhar Venkatesh Murthy Associate Prof. & Head of Pathology School of Medicine.

9. Anatomy:

16. Cholesterolosis of gallbladder mucosa Cholesterol filled Foamy macrophages in mucosal folds

22. Cholelithiasis – Complications.

25. Gallstones (mixed) Note: Yellowish shiny faceted stones, and thick inflammed gallbladder.

26. Pure Cholesterol Gallstones, bleeding. Round, yellow, spiky, bleeding.

27. Cholesterol Gallstones, bleeding. Round, yellow, spiky, bleeding. Note thickened inflammed gall bladder.

28. Cholesterol Gallstones.

29. Pigment stones in hemolytic anemia Note: Dark Black friable soft stones – Bilirubin

30. Gall stones in CBD Stones in CBD Stonees in GB 20% of mixed chol. stones and >50% of pigment stones are radio-opaque

31. Cholecystitis & Gallstones

32. “ What we think, we become” --Buddha

34. Excess Bile - plugs Bile Obstruction leading to Cholestasis & Cholangitis Bile duct inflammation Bile staining

35. Cholestasis: Bile “plugs”, Bile “lakes” Bile Plugs Bile Lakes

36. Excess Bile Bile plug

37. PBC – Microscopy:

38. PBC – Microscopy:

39. PBC – Microscopy:

40. PBC – Microscopy:

41. Macronodular Cirrhosis - PBC

42. Macronodular Cirrhosis - PBC

43. Biliary Atresia in a 3m child. Dark bile stained liver tissue, cirrhosis & death before 2 years of age.

45. Cholangiocarcinoma: Gross Microscopy: Glands in desmoplastic (fibrous) stroma

46. “ Outer world is the reflection of our inner world (thoughts) ” --Baba

48. Carcinoma Gallbladder: Note irregular glandular structures and clusters of similar cells.

50. Carcinoma Bile duct:

51. Adenocarcinoma: Normal Adeno Ca

52. Carcinoma Bile duct:

53. Great wars & Great creations start first in human mind…! -- Thoughts are seeds with potential.

69. “ The ancestor of every action is a thought.” --Ralph Waldo Emerson

84. Self Assessment is the key…! Whether new information is "stored" or "dumped" depends, then, on our Interest , Reciting, Writing & Reviewing the information. Source: http://www.web-us.com/memory/human_memory.htm Retention of Learning Time Delay No review Review 7 Days 33% 83% 63 Days 14% 70%

86. Living becomes a glorious experience only when there is tolerance and love. Willingness to compromise with other people’s ways of living and cooperation in common tasks, these make happy and successful societies. Divine Discourse, 17th February 1980 - Baba. Love is Selfless Service.

88. Silence… To the question "Who am I?" the only relevant answer is silence. You need to discard all answers in words, including "I am Nothing" or "I am the Cosmic Self" or "I am the Self" - and just stick to the question "Who am I?". All other answers are just thoughts. Thoughts can never be complete. Only Silence is complete. Thoughts are not the goal in themselves. Their goal is Silence. When you ask the question "Who am I?" you get no answer, there is silence. That is the real answer. For your soul is solidified silence. This solidified silence is wisdom, is knowledge. The easy way to silence the thoughts is to arouse the feelings. For, through feelings only peace, joy and love dawn. And they are all your very nature. - Sri Sri Ravishankar