Cirrhosis : a practical guide to management

✍ Scribed by Lee, Samuel S.; Moreau, Richard

• Publisher: Wiley-Blackwell
• Year: 2015
• Tongue: English
• Leaves: 353
• Edition: 1
• Category: Library

✦ Synopsis

Cirrhosis: a practical guide to management provides gastroenterologists and hepatologists with an up-to-date clinical guide presenting the very best evidence-based practice in the diagnosis, treatment and management of liver cirrhosis and its many complications.  Designed to offer practical guidance at all times, it provides doctors with an extremely useful tool in the clinical setting, with each chapter featuring diagnostic/management algorithms, key points and other pedagogic features.

Divided into 2 parts, a diagnosis and pathophysiology section and a management of complications section, key topics include:

- Diagnostic laboratory tests
- Diagnostic imaging modalities
- Acute-on chronic liver failure
- Agents and drugs to avoid
- End stage liver failure: liver transplant evaluation
- Hepatocellular carcinoma

Aimed at the specialist, as well as the practicing trainee at the top-end of specialty training, the emphasis throughout is on providing optimum clinical management guidance most relevant to practicing hepatologists and gastroenterologists, and is an invaluable guide to this increasingly common condition.

✦ Table of Contents

Content: Cirrhosis: A Practical Guide to Management
Contents
List of contributors
Foreword
List of abbreviations
Part 1: Diagnosis and pathophysiology
1. Clinical clues to the diagnosis of cirrhosis
Introduction
Clinical presentation
Patient history
Abdominal distension (ascites)
Jaundice
Upper gastrointestinal bleeding
Hepatic encephalopathy
Etiologic history taking
Alcohol intake: how much is significant
History of other risk factors
Examination
General examination
Nutritional status
Cutaneous clues
Spider angioma
Palmar erythema
Dupuytren's contracture
Leukonychia. Muehrcke's nailsBier spots
Paper-money skin
Hypogonadism and gynecomastia
Parotidomegaly
Other manifestations
Abdominal examination
Abdominal veins
Cruveilhier-Baumgarten murmur
Examination of the liver
Examination of the spleen
Examination for ascites
Neurologic examination
References
2. Diagnostic laboratory tests
Introduction
Tests that detects hepatic injury (Table 2.1)
Serum aminotransferases
Serum biliary enzymes
Tests of hepatic metabolism (Table 2.1)
Serum bilirubin
Serum ammonia
Indocyanine green and bromsulphalein tests. Tests of hepatic biosynthetic function (Table 2.2)Serum albumin
Prothrombin time and international normalized ratio
Individual serum coagulating factor levels
Factor VIII
Factors V and VII
Cell counts and other biochemistry (Table 2.2)
Thrombocytopenia
Neutropenia
Anemia
Globulins
Hyponatremia
Accuracy of routine laboratory investigations (Table 2.3)
Combination indices or models for detecting cirrhosis (Table 2.4)
Specific tests for determining the etiology of liver cirrhosis
Tests for viral hepatitis
Tests for alcoholic liver disease
Tests for primary biliary cirrhosis. Tests for primary sclerosing cholangitisTests for hereditary hemochromatosis
Transferrin saturation
Plasma ferritin level
Tests for Wilson's disease
Serum ceruloplasmin
Serum copper
Urine copper excretion
Tests for alpha-1 antitrypsin deficiency
Conclusions
References
3. Diagnostic imaging modalities
Ultrasonography-based approaches
Grayscale and Doppler US
Contrast-enhanced ultrasonography
Measurement of liver stiffness: transient elastography, acoustic radiation force impulse, supersonic shear-wave elastography, and real-time elastography
CT- and MRI-based approaches. Morphologic changesHemodynamic changes
MR elastography
Other imaging techniques
References
4. Histology/pathology
Introduction
Cirrhosis: a pathologic spectrum
Fibrosis: extracellular accumulation of matrix components
Vascular changes
Parenchymal nodules: etiologic features
Cirrhosis: an evolving concept
Cirrhosis: a preneoplastic condition
Cirrhosis: a place for biopsy?
References
5. Fibrosis and fibrogenesis
Introduction
Mechanism of liver fibrosis in hepatitis B and C
Diagnosis of liver fibrosis by imaging
Diagnosis of liver fibrosis by laboratory tests.