Portal Hypertension = increased resistance to flow through liver -> shunted around the other collateral vascular beds; the most common complication of cirrhotic liver disease
Hepatic veno-occlusive disease aka sinusoidal obstruction syndrome (SOS) important complication of stem cell transplantation (SCT) mortality >30%
Acute or ascending cholangitis is a potentially life-threatening systemic infection resulting from inflammation and infection of the biliary tree due to bacterial growth in the bile, usually in the context of biliary obstruction
Gastrointestinal Literature Summaries
Coagulopathy in Liver Dysfunction; defined as INR >1.5 due to liver dysfunction; patients are not 'auto-anticoagulated' - they are often in a procoagulant state!
Pseudomembranous colitis (PMC); acute inflammatory disease of colon commonly associated with antibiotic use; C. difficile implicated as a causative organism in 1970’s
Portopulmonary Syndrome is NOT considered contraindication to liver transplantation; affects ~20% of pre-transplant patients; usually due to increased blood flow through the lungs without increased resistance
Hepatopulmonary Syndrome = hepatic dysfunction + intrapulmonary vasodilation -> gas exchange abnormalities; imbalance between intrapulmonary vasoconstriction and vasodilation at the pre- and post-capillary level
Tintinalli Gastroenterology multiple choice questions MCQs for ACEM Fellowship
Gastric residual volume is the amount aspirated from the stomach following administration of enteral feed. An aspirated amount of ≤ 500ml 6 hourly is safe and indicates that the GIT is functioning
A patient is day 1 post-laparotomy. his abdomen feels tight and his urine output has dropped off... Can you save the day in this gastrointestinal gutwrencher?
You are assessing a 37 year old male in the emergency department. He appears to be in discomfort and states that he fell asleep at a party and thinks ‘someone put something up his back passage while he was out of it’.