A overview of scientific and surgical difficulties affecting the liver, pancreas and biliary process. This publication presents the fundamental details for clinical and nursing scholars, GPs and junior health center medical professionals often scientific and surgical education. It offers algorhithms for diagnosing and treating universal illnesses (e.g. gallstones, hepatitis) in addition to info for referring, and permitting trained dialogue with sufferers relating to remedy and diagnosis of rarer stipulations similar to malignancies and transplantation.
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Additional resources for ABC of Liver, Pancreas and Gall Bladder (ABC Series)
Diagnosis Ascites may not be clinically detectable when present in small volumes. In larger volumes, the classic findings of ascites are a distended abdomen with a fluid thrill or shifting dullness. Ascites must be differentiated from abdominal distension due to other causes such as obesity, pregnancy, gaseous distension of bowel, bladder distension, cysts, and tumours. Tense ascites may cause appreciable discomfort, difficulty in breathing, eversion of the umbilicus, herniae, and scrotal oedema.
Hepatic echinococcosis. In: Cameron JL, ed. Current surgical therapy. 6th ed. Baltimore, MA: Mosby, 1998:326-30 The picture of the trophozoite was supplied by David Mirecman, University of Utah. 8 Operative specimen of opened hydatid cyst showing multiple daughter cysts Summary points x Most patients with pyogenic abscesses will require percutaneous drainage and antibiotics x A cause can be identified in 85% of cases of liver abscess, most commonly gall stones, diverticulitis, or appendicitis x Amoebic abscesses can be treated by metronidazole alone in 95% of cases x Hydatid disease occurs throughout the world in sheep farming areas x Symptomatic hydatid cysts should be surgically removed 10 Acute pancreatitis I J Beckingham, P C Bornman Acute pancreatitis is relatively common, with an annual incidence of 10-20/million population.
This avoids inappropriate diagnostic laparotomy. Patients who are thought to have severe pancreatitis or in whom treatment is failing to resolve symptoms should have contrast enhanced computed tomography after 72 hours to look for pancreatic necrosis. 4 Computed tomogram showing extensive mesenteric oedema caused by retroperitoneal fluid due to acute pancreatitis Acute pancreatitis Treatment of acute attacks Mild pancreatitis Treatment of mild pancreatitis is supportive. Patients require hospital admission, where they should receive intravenous crystalloid fluids and appropriate analgesia and should stop all oral intake.