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Liver, Biliary Tract and Pancreatic Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
AIC and autoimmune pancreatitis (AIP) are chronic fibroinflammatory diseases of the biliary tree and pancreas that belong to the spectrum of Ig G4-related diseases (IgG4-RD). The conditions present with obstructive jaundice. IgG4 levels are often elevated.Histologically, there is lymphoplasmacytic acinar inflammation and storiform.Initial treatment of both is with high-dose corticosteroids for 4 weeks followed by a gradual taper. Relapses are common and often require treatment with immunomodulators and, more recently, rituximab.
Xanthelasma
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
Other conditions include: Familial type 3 hyperlipoproteinaemia.Diabetes mellitus.Hypothyroidism.Nephrotic syndrome.Chronic obstructive jaundice.
Gastrointestinal cancer
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
Other causes of obstructive jaundice include: GallstonesCarcinoma of the head of the pancreasCarcinoma of the ampulla of VaterBenign biliary tract stricture following surgical traumaSclerosing cholangitisLymph node metastases at the porta hepatis
Risk factors of recurrent pancreatitis after first acute pancreatitis attack: a retrospective cohort study
Published in Scandinavian Journal of Gastroenterology, 2020
Joon Hyun Cho, Yo Han Jeong, Kook Hyun Kim, Tae Nyeun Kim
It is important to identify the risk factors for RAP, such that necessary action can be taken to prevent repeat attacks. Previous studies have revealed various risk factors of RAP. Zhang et al. [19] reported obstructive jaundice, liver injury, and local complications are risk factors. Bertilsson et al. [23] reported a significantly higher risk of RAP among smokers and patients with alcohol-associated AP, organ failure, or a local complication at index admission. Vipperla et al. [24] also reported local complication as a risk factor of early hospital readmission. Although reports differ slightly, possibly because of different geographic and population characteristics, quality of medicine and medical care, and study design (e.g., heterogeneity of follow-up durations), the definition of RAP, and the evaluation protocol used, these findings commonly suggest male gender, alcohol-associated AP, and a local complication at index admission are typical risk factors of RAP.
The Effect of Calcium Dobesilate on Liver Damage in Experimental Obstructive Jaundice
Published in Journal of Investigative Surgery, 2019
Yilmaz Unal, Salih Tuncal, Koray Kosmaz, Berkay Kucuk, Kemal Kismet, Turgut CAVUSOGLU, Pinar Celepli, Mehmet Senes, Selin Yildiz, Sema Hucumenoglu
Obstructive jaundice is a disorder that emerges due to the inhibition of the flow of bile from liver to intestines associated with blockage within the intra- or extra-hepatic bile ducts. This obstruction causes the accumulation of bilirubin and toxic bile acids in blood and liver cells. Obstruction in the bile ducts leads to certain changes in pathology in the organism. Main changes are suppression of the immune system, impairments in RES functions, oxidative damage in the intestinal wall, inhibited detergent and antibacterial effects of bile salts because of decreased enterohepatic circulation, endotoxemia, and bacteremia.1 In addition, as a result of stasis in the liver, other findings emerge, such as degeneration in the hepatocytes, impaired liver function tests, bleeding, and prolonged clotting time.2
Surgical approaches for the treatment of perihilar cholangiocarcinoma
Published in Expert Review of Anticancer Therapy, 2018
Charles W. Kimbrough, Jordan M. Cloyd, Timothy M. Pawlik
Many patients who present with obstructive jaundice will initially undergo abdominal ultrasound. While ultrasound demonstrates ductal dilation, it often will not show the location of the tumor or identify metastases to the liver or peritoneum. Instead, contrast-enhanced cross-sectional imaging is the modality of choice to assess cholangiocarcinoma. Either multi-detector computed tomography (MDCT) or magnetic resonance imaging/magnetic resonance cholangiopancreatography (MRI/MRCP) is preferred to evaluate tumor extension and any associated vascular involvement [41–43]. Both techniques yield similar staging accuracy and choice of modality largely depends upon institutional expertise[41]. Suggested protocols for MDCT include the use of arterial and portovenous phases with thin 2–3 mm cuts through the liver[42]. When performed correctly, MDCT may accurately predict resectability in over 90% of patients[44]. Compared with CT, MRI/MRCP may give a clearer delineation of intrahepatic extension but is less predictive of vascular invasion[42]. Imaging studies should be obtained prior to any instrumentation of the biliary tree, as the presence of a biliary stent may limit their interpretation and impede the radiologist ability to review the biliary tree and identify any abnormalities.