Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_66_библиотеки_им_акад_М_И_Перельмана
.pdf
123
Clinical Rounds
in Hepatology
VirendraSingh
AkashRoy
Editors
Clinical Rounds in Hepatology
Virendra Singh • Akash Roy
Editors
Clinical Rounds
in Hepatology
Editors
Virendra Singh
Department of Hepatology
Post Graduate Institute of Medical
Education and Research
Chandigarh, Punjab, India
Akash Roy
Department of Hepatology
Post Graduate Institute of Medical Education
and Research
Chandigarh, Punjab, India
ISBN 978-981-16-8447-0 ISBN 978-981-16-8448-7 (eBook)
https://doi.org/10.1007/978-981-16-8448-7
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore
Pte Ltd. 2022
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether
the whole or part of the material is concerned, specically the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on microlms or in any other physical way, and
transmission or information storage and retrieval, electronic adaptation, computer software, or by similar
or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specic statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, expressed or implied, with respect to the material contained herein or for any
errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional
claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Singapore Pte Ltd.
The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721,
Singapore
v
Part I Clinical Hepatology
1 Approach to Abnormal Liver Function Tests . . . . . . . . . . . . . . . . . . . . . 3
Akash Gandotra, Akash Roy, and Virendra Singh
2 Acute Liver Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Amandeep Singh, Akash Roy, and Virendra Singh
3 Clinical Approach to Hepatitis B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Sunil Taneja, Akash Roy, and Virendra Singh
4 Practical Management of Chronic Hepatitis C . . . . . . . . . . . . . . . . . . . 23
Akash Roy and Virendra Singh
5 Non-alcoholic Fatty Liver Disease (NAFLD) . . . . . . . . . . . . . . . . . . . . . 35
Ajay Duseja, Akash Roy, and Virendra Singh
6 Alcoholic Hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Nipun Verma, Akash Roy, and Virendra Singh
7 Acute on Chronic Liver Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Madhumita Premkumar, Akash Roy, and Virendra Singh
8 Ascites and Spontaneous Bacterial Peritonitis . . . . . . . . . . . . . . . . . . . . 59
Aswath Venkitaraman, Akash Roy, and Virendra Singh
9 Renal Failure in Cirrhosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Arka De, Akash Roy, and Virendra Singh
10 Hepatic Encephalopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Rohit Mehtani, Akash Roy, and Virendra Singh
11 Approach to Variceal Hemorrhage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Arun Valsan, Akash Roy, and Virendra Singh
12 Autoimmune Hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Akash Roy, Virendra Singh, and Ashim Das
Contents
https://t.me/medicina_free
vi
13 Primary Biliary Cholangitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Saurabh Mishra, Akash Roy, and Virendra Singh
14 Primary Sclerosing Cholangitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Akash Roy, Prasanta Debnath, and Virendra Singh
15 Hepatocellular Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
Akash Roy, Virendra Singh, Harish Bhujade, and Naveen Kalra
16 Hepatic Venous Outflow Tract Obstruction . . . . . . . . . . . . . . . . . . . . . . 129
Sahaj Rathi, Akash Roy, and Virendra Singh
17 Sarcopenia and Frailty in Liver Disease . . . . . . . . . . . . . . . . . . . . . . . . . 137
Surender Singh, Akash Roy, and Virendra Singh
18 Miscellaneous Topics in Liver Disease . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Yogendra Kumar, Akash Roy, and Virendra Singh
19 Selected Topics in Transplant Hepatology . . . . . . . . . . . . . . . . . . . . . . . 153
Keisham Amarjit, Akash Roy, and Virendra Singh
Part II Biliary and Pancreatic Disorders
20 Choledocholithiasis and Cholangitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
U. V. U. Vamsidhar Reddy, Akash Roy, and Virendra Singh
21 Approach to Biliary Obstruction and Evaluation
of Biliary Stricture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Prasanta Debnath, Akash Roy, and Virendra Singh
22 Acute Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
Prasanta Debnath, Akash Roy, and Virendra Singh
23 Chronic Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Babu Lal Meena, Akash Roy, and Virendra Singh
Contents
https://t.me/medicina_free
vii
About the Editors and Contributors
About the Editors
VirendraSingh is working as Professor and Head of Hepatology at Postgraduate
Institute of Medical Education and Research, Chandigarh, India, with more than 35
years of teaching experience. He completed his training in gastroenterology from the
Institute of Medical Sciences, Banaras Hindu University, Varanasi, India, in 1988.
He has published more than 135 papers in national as well as international journals.
His areas of interest include ascites, post-paracentesis circulatory dysfunction, hepa-
torenal syndrome, hepatic regeneration in alcoholic hepatitis and cirrhosis, malig-
nant hilar biliary obstruction, biliary injuries, and gastrointestinal tuberculosis.
AkashRoy is Senior Resident (Academic) at the Department of Hepatology, Post
Graduate Institute of Medical Education and Research, Chandigarh. He did his
MBBS from the Regional Institute of Medical Sciences, Imphal, and MD in internal
medicine from NEIGRIHMS, Shillong. He has over 50 publications (national/inter-
national) to his credit and is the recipient of multiple awards in internal medicine
and hepatology. His areas of interest include cirrhosis, alcoholic hepatitis, gut
microbiota, and liver transplantation.
List of Contributors
Keisham Amarjit, MBBS, MD Department of Hepatology, Post Graduate
Institute of Medical Education and Research, Chandigarh, Punjab, India
Harish Bhujade, MBBS, MD Department of Radiodiagnosis, Post Graduate
Institute of Medical Education and Research, Chandigarh, Punjab, India
Ashim Das, MBBS, MD Department of Pathology, Post Graduate Institute of
Medical Education and Research, Chandigarh, Punjab, India
ArkaDe, MBBS, MD, DM Department of Hepatology, Post Graduate Institute of
Medical Education and Research, Chandigarh, Punjab, India
Prasanta Debnath, MBBS, MD, DM Department of Gastroenterology, TNMC
and BYL Nair Charitable Hospital, Mumbai, India
https://t.me/medicina_free
viii
AjayDuseja, MBBS, MD, DM Department of Hepatology, Post Graduate Institute
of Medical Education and Research, Chandigarh, Punjab, India
AkashGandotra, MBBS, MD Department of Hepatology, Post Graduate Institute
of Medical Education and Research, Chandigarh, Punjab, India
Naveen Kalra, MBBS, MD Department of Radiodiagnosis, Post Graduate
Institute of Medical Education and Research, Chandigarh, Punjab, India
YogendraKumar, MBBS, MD
Department of Hepatology, Post Graduate Institute
of Medical Education and Research, Chandigarh, Punjab, India
BabuLalMeena, MBBS, MD Department of Hepatology, Post Graduate Institute
of Medical Education and Research, Chandigarh, Punjab, India
RohitMehtani, MBBS, MD Department of Hepatology, Post Graduate Institute
of Medical Education and Research, Chandigarh, Punjab, India
SaurabhMishra, MBBS, MD Department of Hepatology, Post Graduate Institute
of Medical Education and Research, Chandigarh, Punjab, India
Madhumita Premkumar, MBBS, MD, DM Department of Hepatology, Post
Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India
SahajRathi, MBBS, MD, DM Department of Hepatology, Post Graduate Institute
of Medical Education and Research, Chandigarh, Punjab, India
Akash Roy, MBBS, MD Department of Hepatology, Post Graduate Institute of
Medical Education and Research, Chandigarh, Punjab, India
AmandeepSingh, MBBS, MD Department of Hepatology, Post Graduate Institute
of Medical Education and Research, Chandigarh, Punjab, India
SurenderSingh, MBBS, MD Department of Hepatology, Post Graduate Institute
of Medical Education and Research, Chandigarh, Punjab, India
Virendra Singh, MBBS, MD, DM Department of Hepatology, Post Graduate
Institute of Medical Education and Research, Chandigarh, Punjab, India
Sunil Taneja, MBBS, MD, DM Department of Hepatology, Post Graduate
Institute of Medical Education and Research, Chandigarh, Punjab, India
ArunValsan, MBBS, MD Department of Hepatology, Post Graduate Institute of
Medical Education and Research, Chandigarh, Punjab, India
U.V.U.VamsidharReddy, MBBS, MD Department of Hepatology, Post Graduate
Institute of Medical Education and Research, Chandigarh, Punjab, India
AswathVenkitaraman, MBBS, MD Department of Hepatology, Post Graduate
Institute of Medical Education and Research, Chandigarh, Punjab, India
Nipun Verma, MBBS, MD, DM Department of Hepatology, Post Graduate
Institute of Medical Education and Research, Chandigarh, Punjab, India
About the Editors and Contributors
https://t.me/medicina_free
Part I
Clinical Hepatology
https://t.me/medicina_free
3
© The Author(s), under exclusive license to Springer Nature Singapore Pte
Ltd. 2022
V. Singh, A. Roy (eds.), Clinical Rounds in Hepatology,
https://doi.org/10.1007/978-981-16-8448-7_1
A. Gandotra · A. Roy · V. Singh (*)
Department of Hepatology, Post Graduate Institute of Medical Education and Research,
Chandigarh, Punjab, India
1
Approach toAbnormal Liver
Function Tests
AkashGandotra, AkashRoy, andVirendraSingh
Case Vignette
A 46-year-old married male visits the outpatient department for elevated liver
enzymes detected during annual check-up. He is an information technology profes-
sional with a sedentary lifestyle. He consumes alcohol (60–120gm) on weekends
without any history of binge. He has a history of hypertension and is on 40mg of
telmisartan. Family history was notable for coronary artery disease in his father. On
examination, his height is 167cm and body weight of 88kg with a body mass index
(BMI) of 32.83 g/m
2
and a waist circumference of 89 cm. He has a BP of
136/94mmHg and pulse rate of 88/min. Per abdomen examination is remarkable
for mild hepatomegaly.
Laboratory investigations revealed the following:
Parameter
Values Parameter
Values
Haemoglobin 13.2 INR 1.1
Platelet count 150 HBsAg NR
Total leukocyte count 7000 Anti-HCV Negative
Total bilirubin (Direct) 1.2(0.8) TG/LDL/HDL 282/94/12
AST 92 TSH 3.45
ALT 98 Urea 32
ALP 100 Creatinine 1.1
Albumin 3.5 HbA
1
C 6.8
Abdominal ultrasound: Liver of 12.2cm with regular margins and smooth sur-
face and increased echogenicity. The spleen size was 8 cm, and the portal vein
diameter was 9mm. No presence of any free uid.
https://t.me/medicina_free
Соседние файлы в папке Библиотека им академика М.И. Перельмана