Hepatic Encephalopathy: An Update on the Pathophysiology and Therapeutic Options

Hepatic encephalopathy is a spectrum of reversible neuropsychiatric abnormalities,seen in patients with liver dysfunction and/or portosystemic shunting.One of the most debilitating complications of cirrhosis,encephalopathy affects 30-45% of cirrhotics.In addition to significantly affecting the lives of patients and their caregivers,it is also associated with increased morbidity and mortality as well as significant utilization of health care resources.In this paper,we provide an overview on the pathophysiology,diagnosis,management and newer therapies of hepatic encephalopathy.

异位胰腺组织的胰腺炎:胃出口梗阻的罕见原因

Inflammation in ectopic pancreatic tissue can clinically present with pain or obstructive symptoms,depending on the location of the ectopic tissue.We present a rare case of gastric outlet obstruction secondary to pancreatitis of ectopic pancreatic tissue in the pylorus.

肝硬化合并肝性脑病患者影像学表现

背景与目的:肝性脑病是肝硬化患者的常见并发症,而肝性脑病患者目前并不适宜进行肝移植。本研究旨在明确影像学提示的肝性脑病与患者临床特征的关系。方法:回顾性分析2009-2010年间进行肝移植评估的肝硬化患者。排除肝癌、射血分数不足60%、曾行经颈静脉肝内门体分流术以及未完成评估的患者。单因素分析有统计学意义(P<0.05)的变量纳入多因素逻辑回归模型。结果:共计117例肝硬化患者满足纳入标准入组研究,其中肝性脑病组58例,对照组59例。单因素分析显示,门静脉直径较小、肝前后径较短、肝结节、应用利尿剂/中枢作用药物与肝性脑病的发生密切相关。多因素分析证实了门静脉直径和应用利尿剂/中枢作用药物与肝性脑病的关系。结论:门静脉直径缩小提示肝性脑病的风险增加。找出门静脉直径较小的肝硬化患者,通过进一步的心理学测试来对肝性脑病进行筛查,并采取更积极的措施来处理便秘及其他易导致肝性脑病的因素。