By Ian Beckingham
Queen's clinical Centre, Nottingham, united kingdom. presents an outline of the illnesses of the liver, pancreas, and gall bladder. For citizens, clinical scholars, and common practitioners. Covers universal and infrequent stipulations and contains algorithms for analysis and remedy. colour illustrations. Softcover.
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Additional info for ABC of liver, pancreas and gall bladder
Compromised host defences have been implicated in the development of cryptogenic abscess and may have a role in the aetiology of most hepatic abscesses. Diabetes mellitus has been noted in 15% of adults with liver abscesses. Microbiology Most patients presenting with pyogenic liver abscesses have a polymicrobial infection usually with Gram negative aerobic and anaerobic organisms. Most organisms are of bowel origin, with Escherichia coli, Klebsiella pneumoniae, bacteroides, enterococci, anaerobic streptococci, and microaerophilic streptococci being most common.
Endoscopic control of gastric varices is difficult unless they are located on the proximal lesser curve in continuation with oesophageal varices. Endoscopic administration of cyanoacrylate monomer (superglue) is useful for gastric varices. The transjugular intrahepatic portosystemic shunt is increasingly used to control bleeding in this group. Bleeding from portal hypertensive gastropathy accounts for 2-3% of bleeding episodes in cirrhosis. Although serious bleeding from these sources is uncommon, when it occurs its diffuse nature precludes the use of endoscopic treatment, and optimal management is with a combination of terlipressin and blockers.
Increasing migration and world travel have made hydatidosis a global problem of increasing importance. Human infection follows accidental ingestion of ova passed in dog faeces. The ova penetrate the intestinal wall and pass through the portal vein to the liver, lung, and other tissues. Hydatid cysts can develop anywhere in the body, but two thirds occur in the liver and one quarter in the lungs. 5 Lifecycle of Echinococcus granulosus Presentation Patients with a liver hydatid may present either with liver enlargement and right upper quadrant pain due to pressure from the cyst or acutely with a complication.