By Ian Beckingham
Queen's scientific Centre, Nottingham, united kingdom. offers an summary of the ailments of the liver, pancreas, and gall bladder. For citizens, scientific scholars, and basic practitioners. Covers universal and infrequent stipulations and comprises algorithms for analysis and therapy. colour illustrations. Softcover.
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Extra resources for ABC of liver, pancreas and gall bladder
The gastric balloon is then inflated with 200 ml of air. Once fully inflated, the gastric balloon is pulled up against the oesophagogastric junction, compressing the submucosal varices. The tension is maintained by strapping a split tennis ball to the tube at the patient’s mouth. 4 Band ligation of oesophageal varix 19 ABC of Liver, Pancreas, and Gall Bladder The oesophageal balloon is rarely required. The main complications are gastric and oesophageal ulceration, aspiration pneumonia, and oesophageal perforation.
All patients should take blockers unless they have contraindications. Best results are obtained when portal blood pressure is reduced by more than 20% of baseline or to below 12 mm Hg. Surgical procedures Patients with good liver function in whom endoscopic management fails or who live far from centres where endoscopic sclerotherapy services are available are candidates for surgical shunt procedures. A successful portosystemic shunt prevents recurrent variceal bleeding but is a major operation that may cause further impairment of liver function.
Hepatic coma, especially in alcoholic patients, should be diagnosed only after coma due to intracranial space occupying and vascular lesions, trauma, infection, epilepsy, and metabolic, endocrine, and drug induced causes has been excluded. Hepatic encephalopathy is a hallmark of deteriorating liver function, and patients should be assessed early for liver transplantation. Hepatocellular insufficiency and portosystemic shunting may act separately or in combination to cause encephalopathy. Almost all cases of clinically apparent hepatic encephalopathy occur in patients with cirrhosis.
ABC of liver, pancreas and gall bladder by Ian Beckingham