1 / 10

Hepatobiliary disease

Gall stones / Pathophysiology. Bile facilitates the absorption of lipids and fat-soluble vitaminsBilirubin, bile salts, phospholipids, and cholesterol Failure to maintain cholesterol and calcium salts in a solubilized state Classified by their cholesterol content as: cholesterol or pigment Pigme

jena
Télécharger la présentation

Hepatobiliary disease

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. Hepatobiliary disease Mazen Hassanain

    2. Gall stones / Pathophysiology Bile facilitates the absorption of lipids and fat-soluble vitamins Bilirubin, bile salts, phospholipids, and cholesterol Failure to maintain cholesterol and calcium salts in a solubilized state Classified by their cholesterol content as: cholesterol or pigment Pigment stones are further classified as either black or brown.

    3. Types / cholesterol 75% cholesterol, Biliary sludge: in prolonged fasting states or with the use of long-term TPN Cholesterol supersaturation is present in many normal humans without gallstones Nucleation Stone growth

    4. Type / Pigment 25% black pigment Hemolytic conditions or cirrhosis Not associated with infected bile 5% brown pigment Earthy in texture and are typically found in the bile ducts, especially in Asian populations. Disorders of biliary motility and associated bacterial infection

    5. Biliary colic 1% / year role Symptoms (meal, 60 min, 1-5h) Diagnosis Nuclear scan Treatment Acute attack Other complications

    6. P/E Exam Acute abdomen Murphys sign, Courvoisiers sign.

    7. Acute pancreatitis Acute Pancreatitis Biliary tract stones Drugs ERCP Ethanol abuse Hypercalcemia Hyperlipidemia Idiopathic Infections Ischemia Parasites Postoperative Scorpion sting Trauma Chronic Pancreatitis Autoimmune Duct obstruction Ethanol abuse Hereditary Hypercalcemia Hyperlipidemia Idiopathic

    8. Ransons Prognostic Signs Admission Gallstone Pancreatitis Age > 70 yr WBC > 18,000/mm3 Glucose > 220 mg/100 mL LDH > 40 IU/L AST > 250 U/100 mL Non-Gallstone Pancreatitis Age > 55 yr WBC > 16,000/mm3 Glucose > 200 mg/100 mL LDH > 350 IU/L AST > 250 U/100 mL Initial 48 Hours Gallstone Pancreatitis Hct fall > 10 BUN elevation > 2 mg/100 mL Ca2+ > 8 mg/100 mL Base deficit > 5 mEq/L Fluid sequestration > 4 L Non-Gallstone Pancreatitis Hct fall > 10 BUN elevation > 5 mg/100 mL Ca2+ > 8 mg/100 mL Pao2 > 55 mm Hg Base deficit > 4 mEq/L Fluid sequestration > 6 L

    9. Chronic pancreatitis Symptoms Complications Acute Complications Chronic Pseudocyst Pathophysiology Symptoms Diagnosis

    10. Pancreatic neoplasm Pathology Symptoms Diagnosis

More Related