LIVER, GALLBLADDER AND PANCREAS Flashcards
Separates the true left and right lobes of the liver
Cantlie’s line
What separates the left lateral and left medial segments of the liver? This also anchors liver to the anterior abdominal wall
Falciform ligament
This ligament anatomically divides this liver to small left lobe and small right lobe (not true division)
Falciform ligamenet
Mickey mouse sign
Porta hepatis
What composes the porta hepatis?
Common bile duct
Hepatic artery
Portal vein
Divides the left lobe into left lateral and left medial sector
Left portal incisure
This is dorsal to the hepatoduodenal ligament
Epiploic foramen of winslow
Segment 1 of Liver
Caudate or Spigelian lobe
Segment 2 and 3
Left lateral segment
Segment 4
Left medial segment
Segment 5 and 8
Right anterior segment
Segment 6 and 7
Right posterior lobe
Blood supply of the liver
Portal vein (75%)
Hepatic artery (25%)
This maneuvers compresses the hepatoduodenal ligament to lessen the blood supply the liver
Pringle’s maneuver
What encompasses the hepatoduodenal ligament?
Portal vein
Hepatic artery
Common bile duct
ThiS measures liver SYNTHETIC functions
Albumin
Clotting factors (except factor 8)
Prothrombin time
INR
When will jaundice be detectable?
If serum bilirubin is more that 2.5 to 3 mg/dL
2 requirements for diagnosis of cirrhosis
Presence of fibrous tissue
Presence of regenerating nodules
First line of antibiotics for spontaneous bacterial peritonitis
Cefotaxime
Normal portal pressure
5-10 mmhg
Portal HPN
> 5mmhg of IV pressure
15mmhg splenic pressure
How much pressure is necesary for varices to form and bleed?
> 12mmhg
Most accurate method of determining portal hpn
Hepatic venography
Most significant manifestation of portal hypertension and leading cause of morbidity and mortality
Esophageal varices
This is given to reduce index bleed of esophageal varices and reduces moratlity by 50%
Beta blockers eg. Propranolol
Current Preferred drug for acute variceal bleeding
Octreotide
This procedure is reserved for recurrent variceal bleeding despite endoscopic and medical treatment who are not candidate for TIPS and have vasculature unsuitable for shunt operations
Sugiura-Fukugawa procedure
Most definitive form of therapy for complications of portal hypertension
orthotopic liver transplantation
Most common route of infection leading to pyogenic liver absces
Ascending route via biliary tree or portal vein
More frequent lobe that is affected by pyogenic liver abscess
Right lobe
Most common organism causing pyogenic liver abscess
E. Coli
Causative agent for amoebic liver abscess
Entamoeba histolytics
Most common form of liver abscess worldwide
Amoebic Liver abscess