diseases of the stomach and small intestine

... system The confluence takes place at the right of the hilus of the liver, anterior to the portal venous bifurcation and overlying the origin of the right branch of the portal vein (Fig 1.5) The biliary ... duct, anterior and lateral aspect of the portal vein, the posterior aspect of the pancreas, between the aorta and the inferior vena cava, and the left aspect of the aorta under the left renal ... [15]: 1 The superior pathway of nodes along the cystic duct, the hepatic duct, the anterior and medial aspect of the portal vein, and the celiac axis 2 The inferior pathway of nodes along the cystic

Ngày tải lên: 09/08/2014, 14:22

... necrosis and scattered plasma cells, further resembling autoimmune hepatitis A high index of suspicion on the part of the gastroenterologist and the pathologist is often necessary to make the diagnosis ... view of this hypothesis, it is interesting that the coexistence of cystic fibro-sis and ADPKD appears to reduce or delay formation of renal and hepatic cysts [67] The interaction of polycystin-1 and ... secondary event and not the inciting factor The gallbladder is edema-tous and congested The mucosa is often but not invariably ulcerated, and there may be areas of granulation tissue and fibroblast

Ngày tải lên: 09/08/2014, 14:22

... has 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 ... profound segmental atrophy, particularly in the anterior segment of the right hepatic lobe and the medial segment of the left hepatic lobe Furthermore, there are often enlarged lymph nodes in the ... dilatation of the bile duct without clear pathology Release of bile into the duodenum is not continuous but regulated by the activity of the sphincter of Oddi, a ring of smooth muscle at the level of the

Ngày tải lên: 09/08/2014, 14:22

... drained directly into the stomach This is done by transhepatic perforation of the left lobe of the liver into the lesser curvature of the stomach using fluoroscopic, endoscopic, and laparoscopic guidance ... di-latation of the common bile duct in the wall of the duode-num, accounting for 5% Type IV is made up of multiple cysts involving the extrahepatic and/or intrahepatic ducts and accounts for 10% of cases ... enters the biliary tree during the puncture by the PTC needle The suspected presence of blood clots requires repeating the cholangiogram in several days The lytic prop-erties of bile and the passing

Ngày tải lên: 09/08/2014, 14:22

... of more than four segments of the liver Figure 8.8 The liver is pulled up and the ligamentum teres downwards The duct of S III can be approached by dissecting the left part of the base of the ... lapa-in the operatlapa-ing room: the suplapa-ine position with the surgeon standing on the left and the assisting surgeon holding the camera on the right side of the patient Alternatively, the pa- ... from the ob-Figure 9.2 The triangle of Calot Dissection of the tissue until the base of the liver bed is exposed When the triangle of Calot is dissected free, the two structures entering the

Ngày tải lên: 09/08/2014, 14:22

... the first 36 to 72 hours from the onset of symptoms With the introduction of laparoscopic cholecystectomy at the beginning of the 1990s the question of timing arose again At the beginning of the ... intravenously and will normally be taken up by the liver and then the gall-bladder Uptake by the liver and excretion into the duode-num 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 infl ammation The theoretical aim of fasting is to rest the

Ngày tải lên: 09/08/2014, 14:22

... classification of cystic diseases of the biliary tract • Understand the premalignant nature of cystic diseases of the biliary tract • Understand the role of liver resection for biliary cystadenoma and cystadenocarcinoma ... lesions of the intra- and extrahepatic bile ducts How-ever, because of the assumed role of the intrahepatic biliary epithelium in the origin of the noncommunicating liver cysts, this group of cystic ... diagnosis of acute angitis The choice between ERCP and PTC depends on the availability of local expertise and the nature and level of bili-ary obstruction Both imaging can define the extent of ductal

Ngày tải lên: 09/08/2014, 14:22

... understanding of the pathophysiology of primary sclerosing cholangitis (PSC), the progression of disease and eventual outcomes become logical • To present the various options of therapy — their ... in animal models [64,65]. Further inves- tigation to delineate the role of these peptides in the etiology of PSC is required. The major criticism of the theories of colonic toxins caus- ing PSC ... of alka- line phosphatase in the setting of chronic ulcerative colitis should raise the suspicion of sclerosing cholangitis and trig- ger further investigation. Early in the course of PSC, the

Ngày tải lên: 09/08/2014, 14:22

... leaflet of membranes, similar to the “flippase” activity of MDR3 The protein is expressed in the small intestine and pancreas with lower expression in the liver, including cholangiocytes and the canalicular ... hepatocytes and facilitates the transport of organic anions bound to albumin, including bile salts and their conjugates and bilirubin, into the liver The restricted site of expression of OATP1B1 ... regulating the de novo synthesis of primary bile acids from cholesterol, expression of bile salts, and organic anion trans-porters in both hepatocytes and enterocytes, and in the re-sponse of the liver

Ngày tải lên: 09/08/2014, 14:22

... portal hypertension and may exacerbate the bleeding from varices in the stomach and esophagus. One of the more intriguing aspects of CHF is the associa-tion with cysts of the extrahepatic biliary ... number of ways, and often is associated with renal disease of varying severity First described in 1962 [165], the most important features of the disease and the complications that accompanied the ... some degree of failure of the normal formation of the inter- lobular bile ducts, and results in a characteristic portal tract lesion consisting of persistence of some remnant of the ductal plate

Ngày tải lên: 09/08/2014, 14:22

... anomalies of the biliary tract, 592 Absence of the gallbladder, 592 Congenital adhesions to the gallbladder, 594 Floating gallbladder and torsion of the gallbladder, 594 Anomalies of the cystic duct and ... of the ampulla of Vater, 644 Cystic tumours of the pancreas, 644 Endocrine tumours of the pancreas, 644 Benign lesions of the gallbladder, 647 Carcinoma of the gallbladder, 647 Other tumours, ... sectors and segments, 2 Anatomy of the biliary tract, 3 Development of the liver and bile ducts, 4 Anatomical abnormalities of the liver, 4 Sinusoidal membrane traffic, 16 Bile duct epithelial

Ngày tải lên: 10/08/2014, 15:20

... erythema (liver palms) The hands are warm and the palms bright red in colour,especially the hypothenar and thenar eminences andpulps of the fingers (fig 6.12) Islets of erythema may befound at the ... telangiectasis The lesions are usually on the upper body Mucosal ones are commoninside the nose, on the tongue, lips and palate, and in the pharynx, oesophagus and stomach The nail beds,palmar surfaces and ... (fig 4.6) The cells are of all types and varying maturity The distribution of cells may reflect the type of underlying sinusoidal endothelial cell [4] There are many reticulum cells and these may

Ngày tải lên: 10/08/2014, 15:20

... diaphragmo-oesophageal and azygos minor veins of the caval system Deviation of blood into these chan-nels leads to varicosities in the submucous layer of the lower end of the oesophagus and fundus of the stomach ... colon and head of the pancreas, and irregularly from the stomach via the right gastro-epiploic vein The splenic veins (5–15 channels) originate at the splenic hilum and join near the tail of the ... bypass the block and return blood towards the liver These enter the portal vein in the porta hepatis beyond the block They include theveins at the hilum, venae comitantes of the portal veinand hepatic

Ngày tải lên: 10/08/2014, 15:20

... liver increases the venous return and the jugular venous pres- sure rises due to the inability of the failing right heart to handle the increased blood flow. The hepato-jugular reflux is of value for ... from the intestine may contribute. Serum transaminases are higher in acute than chronic failure and are proportional to the degree of shock and the extent of zone 3 necrosis. The association of ... bile, presumably as a result of the failure of transport systems across the hepato- cyte and the canalicular membrane. Conjugation is intact and therefore there is reflux of conjugated bilirubin into

Ngày tải lên: 10/08/2014, 15:20

... serum IgG anti-HDV is found There may be a window period between thedisappearance of one and the detection of the other Loss of IgM anti-HDV confirms the resolution of HDV tion, whereas persistence ... Fig 17.3 The hepatitis B virion enters the hepatocyte and the core reaches the nucleus At first the virus replicates using its own viral DNA Then the viral DNA integrates with host DNA and the host ... to 0.2% in Britain, the USA and Scandinavia, to more than 3% in Greece and southern Italy and even up to 10–15% in Africa and the Far East If anti-HBs is measured, the rate of exposure to hepatitis

Ngày tải lên: 10/08/2014, 15:20

... is the fourth commonest cause of death in adult males The prevalence of alcoholic liver disease depends largely on religious and other customs and on the relation between the cost of alcohol and ... related to the severity of theliver disease [72] The extent of the nutritional defectdepends on the type of alcoholic, whether of low socio-economic status where protein-calorie malnutritionoften ... synthesis of connective tissue There is interaction between stellate cells and adjacent sinusoidal and parenchymal cells, cytokines and growth factors, proteases and their inhibitors, and the

Ngày tải lên: 10/08/2014, 15:20

... excreta of dogs, often duringchildhood The dog is infected by eating the viscera ofsheep, which contain hydatid cysts Scolices, contained in the cysts, adhere to the small intestine of the dog andbecome ... features These depend on the site, the stage and whether the cyst is alive or dead The rest of the liver hypertrophies and hepatomegaly results The uncomplicated hydatid cyst may be silent and found ... vegetative form and as cysts, which survive outside the body and are highlyinfectious The cystic form passes unharmed through thestomach and small intestine and changes into the vegeta-tive,

Ngày tải lên: 10/08/2014, 15:20

... of the ventral wall of the primitive foregut just cranial to the yolk sac Two solid buds of cells form the right and left lobes of the liver while the original elon-gated diverticulum forms the ... system and joins the common hepatic duct somewhere between the junction of the main right and left hepatic ducts and the entry of the cystic duct (fig 35.1c) It may, however, join the cystic duct, the ... exaggerated form of Phrygian cap, presumably of the serosal type The constancy of position of thefundus during contraction and the small size of theopening between the two parts indicate that this is

Ngày tải lên: 10/08/2014, 15:20

... depends on the clinical state of the patient and the staging of the tumour derived from radiological imaging Difficulties in removal arise because of the inaccessibility of the pancreas on the pos- ... which there is no acceptable, alternative therapy The patient and the family must understand the magnitude of the under-taking and be prepared to face the difficult early post-operative period and ... pooling in the lower part of the body and splanchnic congestion The cannulae are placed in the inferior vena cava (via the femoral vein) and the portal vein, and run to the subclavian vein The veno-venous

Ngày tải lên: 10/08/2014, 15:20

... The right side of the brain is responsible for the motorand sensory functioning of the left side of the body and theopposite is true for the left-brain The left-brain is alsoresponsible for the ... beings due to the unique anatomy andphysiology of human nervous system Especially the cortex of the brain (the grey layer of the brain surface) is highlyevolved and complex Other organs of the human ... 25percent of the oxygen intake of the body and 70 percent of the total glucose available to the body The lower group of chordate animals do not have a developed organ like brainand therefore their

Ngày tải lên: 12/12/2016, 09:55