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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Endoscopic retrograde cholangiopancreatography (ERCP) is essential in the diagnosis of pancreatic disease, jaundice and in post-cholecystectomy syndromes, as well as in cases where cholecystography and i.v. cholangiography fail to explain disturbances that strongly suggest bile duct involvement. Its confirmation of clinically established pancreatic disease is much more positive than that given by scintiscanning and multiple superselective arteriography. Unlike the latter, it also permits the differential diagnosis of chronic pancreatitis, cancer of the pancreas, pseudocysts, etc. and distinguishes medical and surgical pancreatitis (stenosis, proteinaceous calculi, and obstructing pseudocysts). Differential diagnosis of progressive jaundice on clinical grounds or with the aid of ordinary means of examination is sometimes unsatisfactory. ERCP clearly distinguishes medical and surgical forms, so that exploratory laparotomy is not needed in subjects with liver-cell forms. It also shows the nature, site and extent of extrahepatic obstruction, and points to the organic cause in 79% of cases of postcholecystectomy syndrome. Right hypochondrial pain or intermittent jaundice and negative cholecystography and i.v. cholangiography is a further indication, since ERCP will reveal disease of the pancreas or bile ducts (cholelithiasis, choledocholithiasis, sclerosing cholangitis, etc). It is also useful in the diagnosis of cirrhosis, abscess, echinococcus cyst and primary or secondary cancer in cases where needle biopsy and-or arteriography are either contra-indicated or inconclusive.
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PMID:[Diagnostic value of retrograde cholangiopancreatography by transendoscopic route]. 66 74

The composition of pigment gallstones from patients with and without cirrhosis was compared. Carbonate-containing pigment stones were distinguished from noncarbonate stones by infrared spectroscopy. Calcium was the major cation of each stone group. The major anion in noncarbonate pigment stones was bilirubinate or phosphate, but was carbonate in carbonate stones. The composition of pigment stones from cirrhotic and noncirrhotic patients was similar except that significantly less carbonate was present in carbonate stones, and less pigment (bilirubinate) was present in noncarbonate stones from noncirrhotics. These data suggest that irrespective of the presence of cirrhosis, the formation of noncarbonate pigment stones involves the selective precipitation of calcium bilirubinate and phosphate, whereas carbonate stone formation involves the selective precipitation of calcium carbonate.
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PMID:Pigment gallstone composition in cirrhotic and noncirrhotic subjects. 71 46

An autopsy case of a four-year-old female with congenital dilatation of intrahepatic bile ducts with bilateral medullary sponge kidney is presented. The liver and kidney were investigated by reconstruction with serial sections and the kidney was also studied by microdissection. In this case the dilatations of collecting tubules and intra- and extrahepatic bile ducts were observed. We regard these lesions as developmental anomalies since these sites of both organs are excretory ducts derived from the endoderm. The liver cirrhosis observed at autopsy had developed in the course of the disease because the liver architecture was well preserved in the biopsy material. The patient had fatal cholangitis without cholelithiasis.
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PMID:Congenital dilatation of intrahepatic bile ducts associated with hepatic fibrosis and medullary sponge kidney--reconstruction and microdissection study. 73 21

Grey-scale ultrasonography was performed without access to detailed clinical information in a prospective study of 55 jaundiced patients. Forty-one were eventually proved to have an extrahepatic obstructive cause, and 14 had intrahepatic "medical" disease. Satisfactory ultrasound images were obtained in 54 patients, and the bile duct calibre was correctly reported in 53 (96%). All 14 medical cases were correctly identified. Two patients with gallstones (one with a normal sized duct) were incorrectly classified as medical. A specific and correct disease diagnosis was given in five of the 14 medical cases (one metastases, four cirrhosis), and in 23 of the 41 obstructive cases (12/14 pancreatic cancer, 5/15 gallstones), 5/5 bile duct compression, 1/3 bile duct cancer. Ultrasonography is safe, cheap, and acceptable to patients. It should be the first imaging investigation in jaundiced patients, providing remarkable diagnostic accuracy and important guidance for further management.
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PMID:Grey-scale ultrasonography in cholestatic jaundice. 76 37

Numerous interactions between hormonal contraceptives and liver function have been described. Changed laboratory results do not represent obligatory pathologic conditions or hepatotoxi effects. Some of these changed results are transient, suggesting that liver cells are capable of adaptation. The use of oral contraceptives is contraindicated in the following liver diseases: - recurrent intrahepatic cholestasis (recurrent jaundice of pregnancy, Dubin-Johnson syndrome, Rotor syndrome); - acute disturbances of liver function. In general it is recommended that hormonal contraceptives should not be used by patients with biliary cirrhosis although some authors have stated that chronic disturbances of liver function did not appear to be aggravated by these agents. Impairment of carbohydrate and lipid metabolism needs careful control of the laboratory tests concerned. Due to its low frequency the increased risk of gallstones does not necessitate the withdrawal of the medication. Up to now the interrelationship between the use of contraceptive steroids and the induction of hepatic tumours has not been proven.
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PMID:[Liver function in hormonal contraception]. 82 25

The influence of alimentation on the digestive pathology is very important. In this report the authors review the principal results of epidemiologic studies and animals experimentations. According to this survey of the literature it can be stated that some presumptions exist for: -- the responsibility of diet without vegetal fibers in the frequency of constipation, colonic divercitular disease, piles and hiatal hernia. The comparison of the alimentary habits in the western Europe with rural Africa is very instructive on that matter; -- the responsibility of alcohol consumption, use of hypercaloric regimen and hyperlipidic ingestats as causative factors for chronic pancreatitis; -- the importance of an hypercaloric, hyperlipidic and low residue regimen as etiologic factors in biliary gallstones; -- the role of denutrition and alcoholism in liver steatosis and cirrhosis in developed country; -- more important, perhaps, is the suspicion of the role of nutrition in the development of digestive cancer: alcohol will facilitate oesophageal cancer, alimentary nitrites gastric cancer meanwhile fiberless regimen and biles salts will promote colonic cancer. Impairments of nutrition observed after digestive resections in case of inappropriate alimentation are also analyzed as well as the principal alimentary disturbances related to allergy or enzymatic deficiency.
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PMID:[Dietary behavior and digestive diseases]. 82

Because it has been suggested that an accumulation of false neurochemical transmitters plays a part in the cardiovascular and neurological complications of cirrhosis it appeared worthwhile to study the level of monoamine oxidase in the liver and platelets of cirrhotic patients. In fact a decrease of such activities might explain the increase of false neurotransmitters observed in cirrhotic patients. Other enzyme were also tested: the plasma benzylamine oxidase activity and the liver mixed function oxidases. 13 cases of severe cirrhosis (B, C according to Child classification) and 10 cases of less severe cirrhosis (A according to Child classification) were studied in comparison to patients affected by cholelithiasis. A defect in the level of monoamine oxidase activity of platelets and liver was observed in some cirrhotic patients together with a decrease of the level of the liver mixed function oxidases.
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PMID:Platelet monoamine oxidase, plasma benzylamine oxidase and liver mixed function oxidase in cirrhotic patients. 86 53

Hepatic dysfunction is a common finding in patients with sickle cell disease but viral hepatitis appears to be an unusual complication in the adult SS patient. Only five cases of viral hepatitis were recorded in 378 admissions for SS crisis. In contrast, hepatic crisis occurred as a distinct event in 9% of 88 patients with sickle cell anemia. This entity must be differentiated from acute cholecystitis or viral hepatitis. Transiently abnormal results of hepatitic function tests were observed in another 26 patients with extrahepatic crisis. Cirrhosis is relatively common and often the terminal event in SS disease. Choledocholithiasis and cholecystitis are infrequent complications despite the prevalence of gallstones in SS anemia.
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PMID:Sickle cell hepatopathy. 87 Sep 77

The diagnosis of viral hepatitis was not confirmed in 2976 (22.79%) out of the admitted to the hospital patients for a period of 15 years. What impresses is the percentage growth for the last several years, reaching to 30. This, on one hand is associated with the greater exigence of HEI and with the strong fear of that disease as well as with the improved diagnostic possibilities of the infectious diseases wards on the other. In fact, almost all patients with icterus were admitted to infectious diseases wards, where the differential diagnosis of icterus was made. The first place among the false diagnoses is occupied by liver-bile diseases, progressing with icterus-50.81%, (cholelithiasis-29%, carcinoma-11%, cirrhosis, chronic hepatitis, steatosis, cholangiohepatitis, pancreatitis, etc-10.8%). Second, according to incidence, come the gastrointestinal diseases-13.51%, grippe and grippe-like diseases-13.44%, lung diseases-5.21%, blood-3.80%, heart-3.16%, toxic hepatitis 3.26%, etc. Thirty cases of infectious mononucleosis with icterus are reported as well as 17 patients with liver etzymopathies, syndrome of Dublin--Johnson--6 and Gilbert--Meulengracht syndrome--11. Viral hepatitis diagnosis is not always easy and in many cases it requires a complex of laboratory and other investigations and many years of experience. However, the false diagnosis could be reduced with more than a half with the careful consideration of the epidemic situation, anamnestic and clinical data.
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PMID:[Diagnostic problems of viral hepatitis]. 89 23

On the basis of the results of our surgical treatment of 85 patients with intrahepatic gallstones, effective methods for surgical treatment of this disease were discussed. The operative mortality rate for these patients was 10.6 percent. Most of the fatal cases had long duration of symptoms and showed evidence of hepatic fibrosis or biliary cirrhosis at the time of operation. The results emphasize that, in cases of long duration of symptoms, it is generally necessary to examine thoroughly prior to operation the presence or absence of liver parenchymal injury and to pay deliberate attention to minimizing operative intervention. Especially, in hepatic lobectomy, its indication must be scrutinized carefully assessing the condition of the patient. In our follow-up study, 80 percent of the patients were found living with almost no complaints, 5 patients having occasional bouts of cholangitic attack included 3 patients who had left the hospital having residual gallstones. Including these 3 patients, 7 of 9 patients with residual gallstones showed severe hepatic dysfunction. In general, indications of our operations for different types of patients with intrahepatic gallstones have been evaluated as satisfactory. For the favorable management of intrahepatic gallstones, two points are specially emphasized: thorough scrutinization of liver parenchymal disorder prior to operation, and long-term observation for care of survivors with residual gallstones.
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PMID:Results of surgical treatment for intrahepatic gallstones. 91 68


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