Splenectomy: A Case Study

As the Directors at the Sharp Rees Medical Facility, we will be talking about the liver. The liver is a very important organ in the human body as it does not just perform one function but is involved in multiple tasks. Some interesting facts about the liver; it weighs under five pounds, it has a shape like a half football and everyone is born with one. Just like most other disease or disorder, if the liver has not been taken care of properly there are many negative outcomes that can affect and destroy the liver. There are many complications when the liver is abused or damage for example cancer, hemochromatosis, gallbladder or

One of these symptoms is jaundice, which is characterized by yellowish skin and eyes because of an inability of the liver to remove bilirubin from the blood. Patient with cirrhosis also suffering from itching, due to deposited bile's products in the skin. This patient also suffers from accumulation of fluid in legs that is called edema. As a result of the blockage of blood flow via the liver, fluid accumulation in abdomen which is worsen by the decrease in protein production. Other symptoms include fatigue, weakness, loss of appetite, weight loss and nausea. As the disease progress, complications may develop ,such as varices that happens with cirrhosis patient when the blood flow through the liver slows, so the blood from intestine go back to the vessels of the stomach and esophagus, these vessels are not meant to carry this much of blood so they dilate (varices), with increasing

The sporozites have traveled ot Ed’s liver; how is the function of hepatocytes related to blood?

In the presented case scenario, we have Mr. Gil Martin who is a 55-year-old Hispanic male. He comes in to the clinic today with complaints of weakness, fatigue, and loss of appetite. A student nurse will be precepting your assessment of Mr. Martin and when collecting subjective and objective data it is important to pay close detail to all findings. Ultimately this patient was diagnosis with cirrhosis, which is an abnormal liver condition that leads to irreversible scarring of the liver (National Institute of Health [NIH], 2017), so during assessment we should pay attention to details leading to this diagnosis.

This case study is about Abdul Chidiac, a 51 year old male, married with 4 children. He had a medical history of hypertension, hypercholesterolaemia and cirrhosis with two admissions in the last six months. He is a smoker and drinks beer, 5-6 bottles per day. As Carithers & McClain (2010) explained the patient’s medical history is another indicator of the risk for cirrhosis; the progression to cirrhosis is adaptable and may take time over weeks or many years. Cirrhosis is a liver disease characterized by permanent scarring of the

This is a 43-year-old male who came in ER with complain of weight loss, about 50 pounds in last 4 months, intermittent vomiting, abdominal pain. Patient has been admitted to hospital as an inpatient as his CT scan showed severe bowel perforation and peritonitis. Patient underwent for exploratory laparotomy followed by sigmoidectomy with colostomy. His previous CT scan (02/2016) revealed multiple liver lesions, largest measuring left hepatic lobe 4 x 5.5 cm and the right hepatic lobe as well as multiple periportal and peripancreatic adenopathy in the stomach and pancreas measuring , and periportal node and prominent epigastric notes. He had a CT-guided biopsy of the liver on 03/02/2016 which revealed carcinoma consistent with Stage IV squamous cell carcinoma of stomach and esophagus with metastasized to the liver. The patient has been on chemotherapy, recently completed 3rd cycle on chemotherapy.

Unfortunately, the epidemiology of cirrhosis is not entirely understood. Scaglione et al sought to identify the occurrence of cirrhosis in the US population. The study utilized data collected between 1999-2010 by the National Health and Nutrition Examination Survey and it was determined that the overall occurrence of cirrhosis was 0.27%, which correlates to 633,323 Americans. Socioeconomic factors play a role

Conservative treatment is the first approach in relieving pain and dysfunction caused by osteoarthritis, but when this treatment approach fails to relieve the symptoms a surgical approach might be necessary. Total Hip Arthroplasty is a surgical approach used to alleviate pain and help improve physical functioning in people suffering from osteoarthritis.

Some experts’ ratings had composed a clinical global impression (clinical global impressions (CGI), of illness severity and illness improvement; two to three times). “Liver enzymes SGOT and SGPT were also assessed (twice)”. The results, out of the 40 patients approached, 29 had completed the 12 consecutive weeks of the study and the 11 ended up being dropouts. Six of the patients were in the target group and five secluded in the control group. The symptoms significantly had decreased across the period of the study, but particularly in the treatment compared with the control group ‘(significant time×group interaction)’. Illness severity (CGI severity)

9. Disturbances of the spleen liver and lymph glands demonstrate marked infiltrations enlargements and eventually fibrosis but enlarged liver is more common

During chronic liver disease, hepatocyte cell death results in inflammation that leads to fibrosis. In addition, the loss of functional hepatocytes results in loss of liver functions, such as the ability to metabolize bilirubin and synthesize proteins (e.g., albumin and clotting factors). Under normal conditions, blood flows from splanchnic circulation to hepatic circulation (for removal of bacteria and toxins) via the portal vein, and blood is returned to systemic circulation via the hepatic vein. Because of liver fibrosis, the distortion of hepatic architecture increases resistance to blood flow, resulting in portal hypertension. The portal collaterals relieve some of the pressure in the portal system but may contribute to cirrhosis-related complications such as varices (Liou, 2014).

It was just 8:30 p.m. when I got ready to witness a surgery at Christus Spohn Hospital. As I scrubbed in, the obstetrician informed me about what my eyes were going to observe – childbirth. He told me about the woman’s experience with labor: “I am about to perform cesarean-section on her and I want you to know, that her womb may be empty”. I was shocked to hear such words come out of Dr. Shelton’s mouth. Thousands of questions immediately came to my head. Why would her womb be empty?

According to Middleton, Teefey and Darcy,8 TIPS placement is successful in about 90% of patients, but does hold a complication rate of 10-16%. Research has shown that placement of TIPS as a secondary treatment for variceal bleeding has produced encouraging results. In 13 random clinical trials, including over 900 patients, recurrent variceal bleeding rates were 9-40%, which is superior to endoscopic treatments that have recurrent bleeding rates from 20-60%. This success rate has made TIPS procedures more utilized in the setting of variceal bleeding. Additionally, the same clinical trials indicate that ascites reduction after shunting ranges from 38-84%, which is favorable to large volume paracentesis that reported rates of 0-43%. “Compared with large-volume paracentesis, TIPS improved transplant-free survival and the incidence of recurrent ascites in cirrhotic patients with refractory ascites.”26 There is evidence of an increase in the development of HE in patients who undergo TIPS, whereas endoscopic treatment does not show an increase. Furthermore, HE is twice as likely to occur when paracentesis is performed. An important consideration is that the complication rate for hepatic encephalopathy does increase with TIPS usage whereas it doesn’t with endoscopic treatment and it is twice as likely to occur as when paracentesis is performed.28 Presently, TIPS is often used as a temporary solution for patients who are

Assisted by the preoperative evaluation of liver function and future live remnant volume, accumulating surgical techniques are emerging for safe liver resection in cirrhotic patients. The tricks for assured surgical interventions are centered in preserving as much hepatic parenchyma as possible and increasing the FLR. In this present article, we reviewed

Millions of Americans undergo elective surgery. For many years overnight fasting, up to 12 hrs had been the recommended routine before elective surgery. This practice was instituted to reduce gastric acidity and to reduce the gastric volume for the risk of aspiration of stomach contents and during anesthesia. Patients who had stayed NPO for twelve hours have an increase in anxiety, thirst and fatigue. The combination of anxiety, thirst and fatigue led to poor patient satisfaction and resulted in a longer recovery time, extending postoperative care in the hospitals. The American Society of Anaesthesiologist changed their guidelines in 1999, allowing patients to have clear fluids up to 2 hours before their surgery and nothing to eat up to 6