Monthly Archives: September 2011

Definition: transient elastography

Transient elastography measures liver stiffness using a mechanical shear wave and an ultrasound wave; liver stiffness has a direct correlation with stage of fibrosis.  This non-invasive measure of fibrosis is most useful for confirming your suspicion of cirrhosis, and can … Continue reading

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Pathology: florid duct lesion

Unlike primary sclerosing cholangitis (PSC), the diagnosis of primary biliary cirrhosis (PBC) is made histologically.  Liver biopsy should be pursued if a cholestatic LFT profile is noted in a female patient with a positive anti-mitochondrial antibody (AMA). The florid duct … Continue reading

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IgG subclass 4 disease

Question: A 68 year old female is hospitalized with a sclerosing cholangitis like illness and was found to have involvement in the pancreas (narrow pancreatic duct, enlarged head with questionable mass).  You of course know to order an IgG4 level … Continue reading

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Lecture: NASH- How many hits does it take?

Today’s lecture delved into the pathophysiology of non-alcoholic steatohepatitis.  The first recognized hit that is most often associated with the condition is the increase in free fatty acids (FFA) that are taken into the hepatocyte.  TNF-alpha is among several cytokines … Continue reading

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The Sunday Chronicles

♥   ♦   ♣   ♠ In June of 2012, the suit generally reserved for anatomic parts is up for re-election.  Heart, the incumbent, is poised to retain her seat for another six years, and Falciform Ligament (though divisive) is creating quite … Continue reading

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Definition: porta hepatis

The porta hepatis is located at the underside of the liver, at the confluence of several important anatomic structures including the proximal common bile duct, portal vein, hepatic artery and lymphatics.  For this reason, it is a frequest site of … Continue reading

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Clinical Pearl

Air in the biliary tree?  Before getting too worked up, look back at the patient records to see if there was any local manipulation over the past 6 months.  ERCP with duct cannulation? Sphincterotomy? Stents? These will leave air in … Continue reading

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