A assessment of clinical and surgical difficulties affecting the liver, pancreas and biliary approach. This ebook offers the fundamental details for clinical and nursing scholars, GPs and junior health facility medical professionals quite often clinical and surgical education. It presents algorhithms for diagnosing and treating universal illnesses (e.g. gallstones, hepatitis) in addition to details for referring, and permitting trained dialogue with sufferers concerning therapy and analysis of rarer stipulations reminiscent of malignancies and transplantation.
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Additional resources for ABC of Liver, Pancreas and Gall Bladder (ABC Series)
It does not require treatment unless symptomatic. In a small proportion of patients a firm radiological diagnosis cannot be reached and the distinction from a malignant liver tumour is uncertain. Histological distinction between focal nodular hyperplasia and cirrhosis and between liver cell adenoma and well differentiated hepatocellular carcinoma can be difficult with tru-cut biopsy or fine needle aspiration samples, and biopsy has the added risk of bleeding and tumour seeding. The histology should therefore be determined by surgical resection, which in specialist centres has a mortality of < 1%.
Diseases of the liver and biliary system. Oxford: Blackwell Scientific, 1996 Riordan SM, Williams R. Management of liver failure. In: Blumgart LH, ed. Surgery of the liver and biliary tract. 8 Spontaneous bacterial peritonitis x An infection of ascites that occurs in the absence of a local infectious source x Mainly a complication of cirrhotic ascites x Prevalence is 15% to 20% (including culture negative cases) x Caused by Gram negative enteric bacteria in > 70% of cases 8 Liver tumours I J Beckingham, J E J Krige Tumours of the liver may be cystic or solid, benign or malignant.
Injection of alcohol or radiofrequency ablation can improve survival in patients with small tumours who are unsuitable for transplantation. For larger tumours, transarterial embolisation with lipiodol and cytotoxic drugs (cisplatin or doxorubicin) may induce tumour necrosis in some patients. In patients without cirrhosis, hepatocellular carcinomas usually present late with an abdominal mass and abnormal liver function. Computed tomography has a greater sensitivity and specificity than ultrasonography, particularly for tumours smaller than 1 cm.
ABC of Liver, Pancreas and Gall Bladder (ABC Series) by Beckingham