A overview of clinical and surgical difficulties affecting the liver, pancreas and biliary method. This e-book presents the fundamental info for scientific and nursing scholars, GPs and junior health center medical professionals commonly clinical and surgical education. It presents algorhithms for diagnosing and treating universal illnesses (e.g. gallstones, hepatitis) in addition to info for referring, and permitting educated dialogue with sufferers relating to therapy and analysis of rarer stipulations corresponding to malignancies and transplantation.
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Additional info for ABC of Liver, Pancreas and Gall Bladder (ABC Series)
The clinical presentation may vary considerably and is influenced by the aetiological factor, age, other associated illnesses, the stage of the disease, and the severity of the attack. 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.
Endoscopic therapy in the management of oesophageal varices: injection sclerotherapy and variceal injection. In: Blumgart LH, ed. Surgery of the liver and biliary tract. London: Saunders, 2000:1885-1906 Sherlock S, Dooley J. Portal hypertension. In: Diseases of the liver and biliary system. Oxford: Blackwell Science, 1996 Sarin SK, Lamba GS, Kumar M, Misra A, Murthy NS. Comparison of endoscopic ligation and propranolol for the primary prevention of variceal bleeding. N Engl J Med 1999;340:988-93 Prophylactic management Most patients with portal hypertension never bleed, and it is difficult to predict who will.
One to three bands are applied to each varix, resulting in thrombosis. Band ligation eradicates oesophageal varices with fewer treatment sessions and complications than sclerotherapy. Balloon tube tamponade The balloon tube tamponade may be life saving in patients with active variceal bleeding if emergency sclerotherapy or banding is unavailable or not technically possible because visibility is obscured. In patients with active bleeding, an endotracheal tube should be inserted to protect the airway before attempting to place the oesophageal balloon tube.