By Ian Beckingham
Queen's scientific Centre, Nottingham, united kingdom. presents an summary of the illnesses of the liver, pancreas, and gall bladder. For citizens, scientific scholars, and normal practitioners. Covers universal and infrequent stipulations and contains algorithms for analysis and remedy. colour illustrations. Softcover.
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Extra info for ABC of liver, pancreas and gall bladder
Measurement of urinary amylase activity, which remains high for longer periods, may be helpful in this situation. Although amylase activity may be raised in several other conditions with similar clinical signs (notably perforated peptic ulcer and ischaemic bowel), the increase is rarely more than three times above normal. Serum lipase measurement has a higher sensitivity and specificity, and now that simpler methods of measurement are available it is likely to become the preferred diagnostic test.
True polycystic liver disease is seen as part of adult polycystic kidney disease, an uncommon autosomal dominant disease that progresses to renal failure. Patients nearly always have multiple renal cysts, which usually precede development of liver cysts. Liver function is normal, and most patients have no symptoms. Occasionally the cysts cause pain because of distension of the liver capsule, and such patients may require cyst fenestration or partial liver resection. Thick walled cysts and those containing septa, nodules, or echogenic fluid may be cystic tumours (cystadenoma, cystadenocarcinoma) or infective cysts (hydatid cysts and abscesses; see later article in this series), and patients should be referred for specialist surgical opinion.
With the exception of liver metastases of colorectal cancer, tumour deposits are almost always multiple and seldom amenable to resection. Colorectal liver metastases Around 8-10 % of patients undergoing curative resection of colorectal tumours have isolated liver metastases suitable for liver resection, equivalent to around 1000 patients in the United Kingdom a year. Half will have metastases at the time of diagnosis of the primary tumour (synchronous metastases) and most of the rest will develop metastases within the next three years (metachronous metastases).
ABC of liver, pancreas and gall bladder by Ian Beckingham