Other Diseases of Liver Flashcards
features of pyogenic liver abscesses
solitary, polymicrobial, often found in right lobe of liver
what test is diagnostic for most pyogenic liver abscesses
ultrasound
what type of cells are seen on microscopic analysis of focal nodular hyperplasia
Kupffer cells
major/main cause of pyogenic liver abscess
cholangitis: either from hepatobiliary malignancy or biliary instrumentation
most common organisms are E. coli and Klebsiella
in what patient population are fungal liver abscesses most commonly seen
those with hematologic malignancies and neutropenia
most common cause of Budd Chiari syndrome
myeloproliferative diseases (specifically polycythemia vera)
what anatomic landmark establishes the boundary between segment 4 and segment 5 & 8 of the liver
the middle hepatic vein
amebic liver abscess cause
Entamoeba histolytica
findings on aspiration of amebic liver abscess
“anchovy paste”
treatment of amebic liver abscess
flagyl
most common cause of portal vein thrombosis in children
umbilical vein infection
features of echinococcal cysts on imaging
aka hydatid cyst; calcified cysts with internal septations and daughter cysts
testing for echinococcal cyst?
Casoni skin test
echinococcal cyst treatment
initially give albendazole; then surgically excise or perform PAIR (puncture, aspiration, injection, and reaspiration) therapy after
what vessel passes through the triangle of calot
the right hepatic artery
what segments make up the right liver?
5-8
most common presenting sign of Budd Chiari syndrome?
ascites
absolute contraindications to percutaneous liver biopsy:
patient unable to cooperate with procedure; unable to locate/identify adequate biopsy site
lab abnormalities associated with severe obstructive jaundice besides LFTs:
prolonged PT because of vitamin K deficiency
What is the anatomical landmark between the left and right lobes of the liver?
middle hepatic vein
3 types of liver abscesses
pyogenic (bacterial), amebic (Entamoeba), and echinoccocal
treatment of pyogenic liver abscess
broad spectrum antibiotics and source control (perc drainage)
treatment of amebic liver abscess
metronidazole for 10 days (95% effective)
aspiration or perc drainage only if no clinical response to abx after 5-7 or very large abscesses
treatment of echinococcal cysts
open surgical drainage with care not to spill intracystic contents (risk of anaphylaxis) or aspiration of cystic contents with instillation of scolicidal agents (PAIR procedure)
