Monthly Archives: July 2011

Radiology: Liver abscess

Occasionally, a space occupying hepatic lesion is nothing more than a collection of bacteria and cellular debris- an abscess.  Although attempts at IV antibiotics are sometimes worthwhile in the non-toxic patient, percutaneous drainage is often necessary.  When you are faced with … Continue reading

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Definition: liver fibrosis panel

The liver fibrosis panel (Hepascore; non-invasive serologic panel of fibrosis markers) is an excellent way to avoid a staging liver biopsy, but must be interpreted with caution.  Similar to Fibroscan, it has excellent predictive value at very low and very high … Continue reading

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Lecture: Variceal bleeding

Today’s lecture focused on the management of esophageal and gastric varices, from prophylaxis to the acute bleeding episode.  Here are some of the highlights: – begin prophylaxis only after esophageal varices reach stage II (ie. do not flatten with insufflation) … Continue reading

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Heberden’s nodes, a few casts, a little albumen, mean a few clinkers- too much stoking.  We all have them after forty.  Reduce meat and drink, flush the drain pipes frequently, keep early hours, and you may yet live to a … Continue reading

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Clinical Pearl

Intraoperative splenectomy is indicated during an ABO-incompatible liver transplant.  Why?  Fewer mature lymphocytes (and allograft-directed antibodies) would theoretically be present to cause cellular/antibody mediated rejection.

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The Sunday Chronicles

Mouse 1: Go ahead, you say it. Mouse 2: …okay-umm, we kind of saw the pill label and know that we’re getting the placebo, for whatever that’s worth.

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Clinical Pearl

Sirolimus (Rapamycin) is never given as an initial agent of immunosuppression after liver transplantation.  Why?  Two reasons, each a part of its side effect profile: impaired wound healing and hepatic artery thrombosis.  At this center the following three agents are … Continue reading

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