Monthly Archives: October 2012

Pathology: hydatid cyst

Posted on October 31, 2012 by thebileflow

The excised hydatid cysts shown here are a beautiful example of a parasitic (tapeworm!) infection with Echinococcus sp.  Although the liver is the most common organ involved, hydatid cysts can be found in the lungs, muscle, brain and kidneys.  A cyst in the liver … Continue reading →

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Quotation

Posted on October 29, 2012 by thebileflow

The practice of medicine is like walking in the rain and trying to stay dry. – Y. Kletter, MD (c. 2002)

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The Sunday Chronicles

Posted on October 28, 2012 by thebileflow

The most common cancer after liver transplant is skin cancer.  Wear sunscreen; avoid dark tans.  Love always, Your friendly neighborhood hepatologist.  Happy Halloween!

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Infiltration

Posted on October 26, 2012 by thebileflow

An elevated alkaline phosphatase (and GGT) is your clue to an infiltrative liver disease, like lymphoma or sarcoid, particularly when elevated in isolation.

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Haiku: NASH

Posted on October 25, 2012 by thebileflow

O2 radicals Junk up mitochondria And the alarm sounds

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Diuretic use

Posted on October 24, 2012 by thebileflow

Question:  A 63 year old cirrhotic female with diuretic-responsive ascites reports that she feels unsteady on her feet, and nearly fell on multiple occasions.  She is on a regimen of furosemide 160 mg per day and spironolactone 400 mg per … Continue reading →

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Clinical Pearl

Posted on October 23, 2012 by thebileflow

Metabolic bone disease is so common in end-stage liver disease and post-transplantation.  There are several reasons for this: prednisone use, cyclosporin use, hypogonadism, diabetes mellitus, hypovitaminosis D, hyperbilirubin, cholestatic liver diseases (PBC, PSC).

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Lecture: vWF as a marker of portal hypertension

Posted on October 22, 2012 by thebileflow

This journal club reviewed the recent Hepatology article by an Austrian group that looked at the diagnostic and prognostic potential of von Willebrand factor (vWF).  They aimed to detect clinically significant portal hypertension (ie. HVPG >10mmHg);  and to evaluate levels for … Continue reading →

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The Sunday Chronicles

Posted on October 21, 2012 by thebileflow

Call your doctor if it takes more than 4 hours to get her to move into your bathtub.

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Definition: ischemia/reperfusion injury

Posted on October 19, 2012 by thebileflow

Ischemia/reperfusion injury occurs after temporary deprivation of blood flow to oxygen-dependent hepatocytes followed by reperfusion, as in the cases of liver transplantation, partial hepatectomy and various forms of circulatory shock.  When this phenomenon happens, a complex series of detrimental events happens, … Continue reading →

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