Author Archives: thebileflow

Quotation

Posted on January 20, 2015 by thebileflow

If you know how to write right, write. – Cohen

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Clinical Pearl

Posted on May 9, 2013 by thebileflow

You are screening your cirrhotic patient for varices with an EGD and you detect a long segment of salmon-colored esophageal mucosa.  Instinct tells you to biopsy it and document Barrett’s esophagus.  Careful.  Is there an esophageal varix beneath that tongue … Continue reading →

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Hepatitis B virus

Posted on May 3, 2013 by thebileflow

Question: All of the following are true statements about the treatment of hepatitis B virus (HBV) except: A. advanced fibrosis can be reversed by giving entecavir B. the risk for cancer can be reduced C. tenofovir and entecavir are associated … Continue reading →

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Clinical Pearl

Posted on April 25, 2013 by thebileflow

Remember that kidney failure in the hepatitis C cirrhotic patient might be related to the virus itself! Cryoglobulinemia, membranous glomerulonephritis, MPGN and polyarteritis nodosa are all associated with HCV, and therefore you might entertain a serologic workup that includes a … Continue reading →

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Definition: cold ischemic time

Posted on April 24, 2013 by thebileflow

Cold ischemic time begins when the organ is taken from the donor cadaver and placed in solution for transport and ends after the tissue reaches physiological temperature during implantation procedures.  More than six hours of cold ischemic time puts the … Continue reading →

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Haiku: portopulmonary hypertension

Posted on April 23, 2013 by thebileflow

High right heart pressures Vasoactive drugs might help- To allow transplant

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Terrorism, liver; Venezuelan equine encephalitis

Posted on April 12, 2013 by thebileflow

Venezuelan equine encephalitis is a mosquito -borne viral pathogen that can cause a flu-like human illness with headache and fever.  It can be associated with elevated transaminases.

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Clinical Pearl

Posted on April 10, 2013 by thebileflow

When doing a liver biopsy, don’t forget that the costal vasculature runs alongside the bottom edge of the rib.  Therefore the appropriately guided needle should run along the top of the lower rib of your intercostal space.

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Journal Club: statins prevent hepatocellular carcinoma

Posted on April 1, 2013 by thebileflow

Today’s journal club focused on whether statins prevent hepatocellular carcinoma (HCC).  It was a meta-analysis from a recent Gastroenterology publication (see link below).  Statins (HMG-CoA reductase inhibitors) influence a long cascade of reactions that may affect neoangiogenesis (ie. Ras pathway), and are … Continue reading →

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Definition: trisegmentectomy

Posted on March 29, 2013 by thebileflow

The hepatic trisegmentectomy resects lesions like hepatocellular carcinoma by removing the entire right lobe in continuity with most or all of the medial segment of the left lobe.  For those with advanced portal hypertension, or evidence of liver insufficiency (ie. … Continue reading →

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