A assessment of clinical and surgical difficulties affecting the liver, pancreas and biliary method. This e-book offers the basic info for clinical and nursing scholars, GPs and junior sanatorium medical professionals regularly clinical and surgical education. It offers algorhithms for diagnosing and treating universal ailments (e.g. gallstones, hepatitis) in addition to details for referring, and permitting knowledgeable dialogue with sufferers relating to therapy and diagnosis of rarer stipulations comparable to malignancies and transplantation.
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Additional resources for ABC of Liver, Pancreas and Gall Bladder (ABC Series)
Cystic liver lesions Cystic lesions of the liver are easily identified by ultrasonography. Over 95% are simple cysts. Asymptomatic cysts are regarded as congenital malformations and require no further investigation or treatment as complications are rare. Aspiration and injection of sclerosants should be avoided as it may cause bleeding and infection and does not resolve the cyst. Rarely, simple cysts can grow very large and produce compressive symptoms. These are managed by limited surgical excision of the cyst wall (cyst fenestration), which can usually be done laparoscopically.
In African and Asian countries aflatoxin, produced as a result of contamination of imperfectly stored staple crops by Aspergillus flavus, seems to be an independent risk factor for the development of hepatocellular carcinoma, probably through mutation of the p53 suppressor gene. Seasonal variation in incidence is seen in these countries. In patients with cirrhosis, the diagnosis should be suspected when there is deterioration in liver function, an acute complication (ascites, encephalopathy, variceal bleed, jaundice), or development of upper abdominal pain and fever.
The common potentially reversible causes are sepsis, excessive diuresis or paracentesis, and nephrotoxic drugs. All patients suspected to have hepatorenal syndrome should be given an intravenous colloid infusion to exclude intravascular hypovolaemia as a cause of prerenal azotaemia. Liver transplantation, if otherwise appropriate and feasible, is the only truly effective treatment, and patients have a poor prognosis. Spontaneous bacterial peritonitis Spontaneous bacterial peritonitis is usually the consequence of bacteraemia due to defects in the hepatic reticuloendothelial system and in the peripheral destruction of bacteria by neutrophils.
ABC of Liver, Pancreas and Gall Bladder (ABC Series) by Beckingham