diseases of the liver gallbladder and bile ducts

... and gallbladder, James Toouli and Mayank Bhandari Pathology of the intrahepatic and extrahepatic bile ducts and gallbladder, 21 Kay Washington Epidemiology of diseases of the bile ducts and gallbladder, ... Anatomy and physiology of the biliary tree and gallbladder James Toouli and Mayank Bhandari OBJECTIVES • Describe the anatomy of the liver and biliary tract • Highlight the surgical anatomy of the liver ... the round ligament and umbilical fissure The right lobe is further divided by the gallbladder fossa into the right hemiliver to the right of the gallbladder and the quadrate lobe to the left The...

Ngày tải lên: 09/08/2014, 14:22

... examination They can Chapter 3: Epidemiology of diseases of the bile ducts and gallbladder be distinguished from stones by their fixed position in the gallbladder and by the lack of an acoustic ... abnormalities of the common bile duct They are associated with a 10% risk of developing cholangiocarcinoma [100] Hepatolithiasis is a Chapter 3: Epidemiology of diseases of the bile ducts and gallbladder ... Epidemiology of diseases of the bile ducts and gallbladder Markus H Heim OBJECTIVES • Name risk factors for gallstone disease • Know the prevalence of gallstones • Know the more important complications of...

Ngày tải lên: 09/08/2014, 14:22

... enhancement and thickening of the wall of the extrahepatic bile ducts, and increased enhancement of the periphery of the liver during the hepatic arterial phase Cystic dilatation of the bile duct Congenital ... visualize the bile ducts at their extremes (i.e the peripheral intrahepatic ducts at one end and the distal common bile duct at the other), the central intrahepatic ducts and especially the common ... the advantage of high spatial resolution, which allows depiction of both the lumen and the wall of the bile ducts, but has the disadvantage of imaging only in the axial plane This is offset by multidetector...

Ngày tải lên: 09/08/2014, 14:22

... approaches for the biliary tree and gallbladder by irradiation They further characterized the injury as “vacuolation, swelling, and necrosis of the epithelial cells of the ducts, and by a slow and atypical ... al The role of radiation therapy in cancer of the extra-hepatic biliary system: an analysis of thirteen patients and a review of the literature of the effectiveness of surgery, chemotherapy and ... of patients have an aberrant common bile duct from the left hemiliver to the right bile duct In another 6% of the cases an aberrant bile duct originates from the posterior right side of the liver...

Ngày tải lên: 09/08/2014, 14:22

... for the biliary tree and gallbladder Figure 10.10 The “critical view of safety.” The triangle of Calot is dissected free of all tissue except for cystic duct and artery and the base of the liver ... classical injuries The deceptive flaring appearance is caused by the separation of the cystic and common hepatic ducts or the side of the common hepatic duct and the side of the gallbladder Note ... when the portion of occluded liver is small or if the injury was remote and the liver has atrophied When the injury is recent and the portion of liver affected is large (e.g the whole right hemiliver)...

Ngày tải lên: 09/08/2014, 14:22

... intravenously and will normally be taken up by the liver and then the gallbladder Uptake by the liver and excretion into the duodenum without filling of the gallbladder is indicative for occlusion of the ... treatment the gallstone disimpacts and falls back into the gallbladder, which allows emptying of the gallbladder, resulting in reduction of the inflammation The theoretical aim of fasting is to rest the ... distention of the gallbladder induces the release of mediators, such as prostaglandin E2 and I 2, which cause an inflammatory response within the gallbladder [5] Infection of the accumulated bile fluid...

Ngày tải lên: 09/08/2014, 14:22

... nature of cystic diseases of the biliary tract • Understand the role of liver resection for biliary cystadenoma and cystadenocarcinoma Introduction Cystic lesions of the bile ducts and liver can ... resection of the gallbladder fossa includes which segments of the liver? a I and IVb b IVb and V c V and VIII d IVb and VIII The term “extended cholecystectomy” may encompass a resection of all of the ... Further investigations demonstrate fusiform cystic dilatations of the common bile duct with thickening of the bile duct wall and extension of the cystic abnormalities into the left lobe of the liver...

Ngày tải lên: 09/08/2014, 14:22

... confluence of the left and right main hepatic bile ducts (perihilar: 67% of the cases) [11] The tumor has a tendency to spread along the bile ducts and perineural sheets Distant metastases are rare and ... Further investigation to delineate the role of these peptides in the etiology of PSC is required The major criticism of the theories of colonic toxins causing PSC comes from studies looking at the ... over the last decade as discussed in more detail in Chapters 4, 5, and The first step is an abdominal ultrasound The dilatation of the bile ducts is easily visualized, and the location of the biliary...

Ngày tải lên: 09/08/2014, 14:22

... excluding the gallbladder, and the fundus of the gallbladder is approximated to the dissection at the hilum of the liver In this way, the gallbladder and bile duct act as the conduit through which bile ... atresia of the gallbladder and all external bile ducts Variants include atresia of the proximal hepatic ducts with patency of the gallbladder and distal duct, or atresia of the distal ducts and patency ... atresia) and that the proximal ducts dilate in response to obstruction [32] The operative strategy required will depend on the age of the child, the size of the ducts, and the location of the perforation...

Ngày tải lên: 09/08/2014, 14:22

... Pathology of the intrahepatic and extrahepatic bile ducts and gallbladder b c a d False d True False a 10 c Chapter 3, Epidemiology of diseases of the bile ducts and gallbladder a, e b, c, e a, ... reflects some degree of failure of the normal formation of the interlobular bile ducts, and results in a characteristic portal tract lesion consisting of persistence of some remnant of the ductal plate ... structures that eventually bud off and migrate to the center of the portal tract to become the interlobular bile ducts The ductal plate cells around the periphery of the portal tract normally involute,...

Ngày tải lên: 09/08/2014, 14:22

... 645 Other causes of extrinsic pressure on the common bile duct, 645 37 Tumours of the Gallbladder and Bile Ducts, 647 Benign lesions of the gallbladder, 647 Carcinoma of the gallbladder, 647 Other ... to the skin into the liver substance and extracted This is the quick part of the procedure The tip of the needle is now placed on sterile paper and some of the remaining saline flushed through the ... receptor and ligand are transferred to a compartment of uncoupling of receptor and ligand (CURL) The receptor and ligand separate The receptor returns to sinusoidal plasma membrane and the ligand...

Ngày tải lên: 10/08/2014, 15:20

... especially the hypothenar and thenar eminences and pulps of the fingers (fig 6.12) Islets of erythema may be found at the bases of the fingers The soles of the feet may be similarly affected The mottling ... diameter and is not obliterated by pressure Venous stars are seen on the dorsum of the foot, legs, back and on the lower border of the ribs Palmar erythema (liver palms) The hands are warm and the ... benzodiazepines and barbiturates (fig 7.9) The binding of any of these ligands opens a chloride channel and after the influx of chloride there is hyperpolarization of the postsynaptic membrane, and neuroinhibition...

Ngày tải lên: 10/08/2014, 15:20

... veins of the caval system Deviation of blood into these channels leads to varicosities in the submucous layer of the lower end of the oesophagus and fundus of the stomach (b) At the anus, the superior ... bypass the block and return blood towards the liver These enter the portal vein in the porta hepatis beyond the block They include the veins at the hilum, venae comitantes of the portal vein and ... by the union of the superior mesenteric vein and the splenic vein just posterior to the head of the pancreas at about the level of the second lumbar vertebra It extends slightly to the right of...

Ngày tải lên: 10/08/2014, 15:20

... one another to form septal bile ducts and so on until the two main hepatic ducts emerge from the right and left lobes of the liver at the porta hepatis Small bile ducts distal to the canals of Hering ... tumours and any irregularity and elevation of the right diaphragm due to an enlarged or nodular liver Visualization of the bile ducts This is indicated if the patient is cholestatic (Chapter 13) The ... with the space of Disse Disruption of the tight junction leads to free passage of solute and larger molecules into the canaliculus with loss of the osmotic gradient and cholestasis Canalicular bile...

Ngày tải lên: 10/08/2014, 15:20

... serum IgG anti-HDV is found There may be a window period between the disappearance of one and the detection of the other Loss of IgM anti-HDV confirms the resolution of HDV infection, whereas persistence ... both as monotherapy, and, on the basis of recently completed large trials, in combination with ribavirin The cost and availability makes all these treatments out of reach of the millions of sufferers ... introspection by the patient Antiviral therapy The aim is to control infectivity, eradicate the virus and prevent the development of cirrhosis However, permanent loss of HBeAg and HBV DNA are unusual and...

Ngày tải lên: 10/08/2014, 15:20

... lipids synthesized in the liver itself The origin depends upon the dose of ethanol ingested and the lipid content of the diet After an acute, isolated ingestion of a large dose of ethanol the fatty ... redox state of the liver The hydrogen generated replaces fatty acid as a fuel and is followed by triglyceride accumulation and fatty liver The redox state of the liver changes, protein synthesis is ... related to the severity of the liver disease [72] The extent of the nutritional defect depends on the type of alcoholic, whether of low socioeconomic status where protein-calorie malnutrition often...

Ngày tải lên: 10/08/2014, 15:20

... throughout the world except in New Zealand, Australia and some parts of the west Pacific The Borrelia multiply in the liver, invading liver cells and causing focal necrosis Just before the crisis the ... 627 Liver flukes Cysts are consumed and larvae develop in the duodenum and eventually reach the bile ducts The flukes probably invade the liver through its peritoneal coat and are carried via the ... the liver parenchyma The lesions produced are single or multiple and of variable size The amoebic abscess is usually about the size of an orange The most frequent site is in the right lobe, often...

Ngày tải lên: 10/08/2014, 15:20

... lesions of the liver and bile ducts are increasingly being diagnosed This can be related to the improved methods of imaging the liver and bile ducts, and of liver biopsy Application of such methods ... Diverticula of the gallbladder and ducts Diverticula of the body and neck may arise from persistent cysto-hepatic ducts which run in embryonic life between the gallbladder and the liver The fundal ... forms the lesser omentum The sheet may run from the common bile duct laterally over the gallbladder down to the duodenum, to the hepatic flexure of the colon and even to the right lobe of the liver, ...

Ngày tải lên: 10/08/2014, 15:20

... into the liver They cause complete obstruction of the extra-hepatic bile ducts with intra-hepatic biliary dilatation and enlargement of the liver The gallbladder is collapsed and flaccid If the ... usually used The left lobe of the donor liver is excised and the right lobe anastomosed to the portal vein, inferior vena cava and aorta of the recipient The donor liver hypertrophies and the recipient’s ... Diverticula of the duodenum are often found near the ampulla of Vater, but rarely cause obstruction of the bile duct They are associated with an increased rate of gallbladder and common bile duct...

Ngày tải lên: 10/08/2014, 15:20

... a nodular mass at the angle of the jaw The masses gradually increase in size and number and form sinuses that open onto the face and neck Although infection is often seen in the jaw area, Actinomyces ... in the host following the fly bite The sandfly inoculates the host with the organisms in the promastigote stage Once the organisms are inoculated, they are phagocytized by host macrophages The ... cat, and, in the soil, if they are exposed to the right conditions, will grow into infectious oocysts The tachyzoites are the proliferating form of the organism, and, when present in tissue, they...

Ngày tải lên: 19/02/2014, 08:20