By Ian Beckingham
Queen's scientific Centre, Nottingham, united kingdom. presents an outline of the illnesses of the liver, pancreas, and gall bladder. For citizens, clinical scholars, and basic practitioners. Covers universal and infrequent stipulations and contains algorithms for analysis and therapy. colour illustrations. Softcover.
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Additional info for ABC of liver, pancreas and gall bladder
Continued bleeding during balloon tamponade indicates an incorrectly positioned tube or bleeding from another source. After resuscitation, and within 12 hours, the tube is removed and endoscopic treatment repeated. Alternative management Transjugular intrahepatic portosystemic shunt Transjugular intrahepatic portosystemic shunt is the best procedure for patients whose bleeding is not controlled by endoscopy. It is effective only in portal hypertension of hepatic origin. The procedure is performed via the internal jugular vein under local anaesthesia with sedation.
Modern imaging combined with recent technical advances in liver surgery can now offer many patients safe and potentially curative resections for malignant, as well as benign, conditions affecting the liver. 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.
Successful treatment depends on an accurate diagnosis of the cause of ascites. Paracentesis with analysis of ascitic fluid is the most rapid and cost effective method of diagnosis. It should be done in patients with ascites of recent onset, cirrhotic patients with ascites admitted to hospital, or those with clinical deterioration. The most important analyses are quantitative cell counts, fluid culture, and calculation of the serum:ascites albumin gradient, which reflects differences in oncotic pressures and correlates with portal venous pressure.
ABC of liver, pancreas and gall bladder by Ian Beckingham