Diseases of the Hepatobiliary Tract Flashcards
What 3 structures compose the portal triad?
Hepatic Artery
Portal Vein
Bile Duct
What are the clinical features of Liver Disease?
Filtration failure - portal hypertension
Elimination failure - jaundice
Metabolic failure - acidosis, muscle loss, coagulopathy, hepatorenal syndrome
Describe liver cirrhosis
Replacement of normal liver tissue by scar tissue.
What is portal hypertension?
Increased pressure in the portal vein, commonly brought about by cirrhosis.
What are oesophageal varices?
Enlarged veins in the esophagus, often due to obstructed blood flow through portal vein
Describe caput medusae
Appearance of distended and engorged superficial epigastric veins. Caused by portal hypertension.
How can liver disease result in Encephalopathy?
Failure of filter, elimination and metabolism
Encephalopathy is the hallmark of liver failure.
What can cause liver decompensation (Functional deterioration)?
Infection - e.g. hepatitis Toxins - alcohol Trauma (e.g. surgery) Drugs Variceal bleed Fatty liver disease (FLD) or Non alcoholic FLD
What are symptoms of chronic liver disease?
Jaundice
Encephalopathy
Ascites
Coagulopathy/bleeding
What are the common liver function tests and what do they indicate? (“Liver Blood Tests” but that’s just stupid)
Indicate Liver ‘Distress’
ALT/AST (alanine and aspartate aminotransferases) - hepatocyte damage
Alk Phos/gamma-GT - bile duct damage
What are true tests of liver function?
prothrombin time bilirubin (excretion) albumin Urea/Creatinine pH
Name 5 methods of liver imaging
Ultrasound
Endoscopic ultrasound (EUS)
Computerised tomography (CT)
Magnetic resonance cholangiography (MRCP)
Liver Fibroscan (enhanced liver fibrosis; ELF)
Now used as therapies/interventions rather than imaging:
- Endoscopic retrograde cholangiopancreatography (ERCP)
- Percutaneous transhepatic cholangiography (PTC)
What is the gallbladder?
Fibromuscular organ which stores and concentrates bile.
What causes gallstones?
Cholesterol based; associated with hypercholesterolaemia
Can be formed by reduced bile secretion or defective reabsorption of bile salts
Pigment stones found in those with Haemolytic disorders (high serum bilirubin levels)
What is the function of the pancreas?
Endocrine: Insulin, Glucagon
Exocrine: Amylase, trypsin, chymotrypsin, lipase, bicarbonate
