Anesthetic Considerations for Patients with Liver disease

Anesthetic Considerations for Patients with Liver Disease Preoperative: 1. Assess the Degree of hepatic impairment, Severity, and Hepatic reserve by the Child-Turcotte-Pugh scoring system. 2. AVOID: Premedication, IM injections, Contact with blood or body fluids, unnecessary esophageal instrumentation. Regional Anesthesia: -Regional anesthesia might be used when possible...

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Gilbert’s Disease

Gilbert’s Disease (Idiopathic Unconjugated Hyperbilirubinemia) -An autosomal dominant, benign condition, in which there is a mildly elevated unconjugated bilirubin, without either structural liver disease or hemolytic anemia. -It possibly results from an impaired uptake and conjugation of bilirubin, secondary to a deficiency of UDP glucuronyl transferase. -The diagnosis...

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Hydatid Disease

 Hydatid Disease -Hydatid cysts are the larval stage of the tapeworm, Echinococcus granulosus. -Dogs are the main hosts. Man and sheep are intermediate hosts. -Hydatid disease is not uncommon amongst the mid-Wales farming communities, and up to 26% of farm dogs in this area have E. granulosus. -The incidence is also high in some regions of the Mediterranean, North...

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Budd–Chiari Syndrome

 Budd–Chiari Syndrome -A syndrome caused by obstruction to the hepatic venous outflow and resulting in a clinical picture of hepatomegaly and portal hypertension. It may be secondary to hematological disorders, malignancy, oral contraceptives, heart failure, or constrictive pericarditis. -The three main sites of obstruction are:1-Inferior vena cava2-Large hepatic veins3-Small intrahepatic...

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Esophageal Achalasia

Esophageal Achalasia Definition: A chronic, progressive motor disorder of the esophagus associated with degenerative changes in the myenteric ganglia and vagal nuclei.Components: There are three components: 1-Failure of the lower esophageal sphincter to relax, with an increased resting sphincter pressure, which together results in a functional obstruction 2-Absence of...

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