By Ian Beckingham
Queen's scientific Centre, Nottingham, united kingdom. presents an summary of the ailments of the liver, pancreas, and gall bladder. For citizens, clinical scholars, and normal practitioners. Covers universal and infrequent stipulations and comprises algorithms for prognosis and therapy. colour illustrations. Softcover.
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Extra resources for ABC of liver, pancreas and gall bladder
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. About half of patients with simple cysts have two or more cysts. True polycystic liver disease is seen as part of adult polycystic kidney disease, an uncommon autosomal dominant disease that progresses to renal failure.
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. This allows secondary seeding of bacteria in the ascitic fluid, which is deficient in antibacterial activity. Clinical signs may be minimal, and a diagnostic paracentesis should be performed in any cirrhotic patient who suddenly deteriorates or presents with fever or abdominal pain.
In alcohol induced pancreatitis symptoms usually begin 6-12 hours after an episode of binge drinking. Gall stones should be suspected in patients over 50 years of age (especially women), those who do not drink alcohol, and when the attack begins after a large meal. In patients with an alcohol history and proved gall stones it can be difficult to distinguish between the two causes. A serum alanine transaminase activity greater than three times above normal usually indicates that gall stones are the cause.
ABC of liver, pancreas and gall bladder by Ian Beckingham