Protective by phagocytosis, antibody for- and rigidity over the right hypochon- mation and excretion and destruction of drium area. X-ray-Straight X-ray abdomen shows The cavities contain yellow brown pus rior mesenteric vein and then portal vein. Ultrasound-Useful for both diagnosis • High grade fever ofen accompanied by • The abscess involves the right lobe in 70 and aspiration of the liver abscess. The pus abscess include secondary infection, rupture, may also look green because of its bile basal pneumonia and pleural efusion. Of • In 50 percent cases the pus contains only • Percutaneous drainage-When the abscess course, ultrasound guided aspiration may entamoebae and in the remaining 50 per- does not resolve on medical treatment, be performed for diagnostic and therapeu- cent the pus also conatains streptococci, percutaneous drainage or repeated aspi- tic purposes. Chapter 36 Liver The antibiotic coverage is usually required Pathology treatment for 1 to 2 weeks for optimal results. The hydatid cyst consists of three layers • For small cysts no treatment is necessary. It is due to reaction of the liver to the Medical The pus from the cavity is aspirated fol- parasite. In recurrent and surgically unresectable Percutaneous drainage may fail due to: elastic which can be readily peeled of disease. Endocyst-It consists of single layer of days, 2 weeks rest, then the cycle is repeated ii. Incorrect placement of the catheter within cells (Germinal epithelium) lining the upto 3 cycles. Open Drainage (Future worms) develop from the germinal The intact cyst together with the laminated It is indicated in patients with failure of layer. Hydatid cyst Care must be taken that the cyst does not The overall mortality may be high due to a remains symptomless for quite a long rupture during the operation because the delay in diagnosis and the presence of multi- time and it is ofen diagnosed inciden- liberated scolices may form new cysts. To prevent rupture, the cyst is frst aspi- A falling serum albumin level and pres- Symptoms are usually produced by pres- rated carefully to reduce the tension inside ence of jaundice are bad prognostic signs. In long- parasite is 1cm long with head and three seg- standing cases the walls calcify and a Malignant Hydatid Disease ments, the last segment of which contains completely calcifed cyst indicates a non Tis is caused by Echinococcus multilocula- about 500 ova. The peculiarity of this cyst is that Ova from the dog’s intestine pass on to low sensitivity and specifcity. Tough Differential Diagnosis benign it mimics clinically and prognosti- ↓ Human beings as intermediate host ingest • Hepatoma.
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Calcium varies according to the vitamin A content of food and hydroxide taken in betel as slaked lime is absorbed and fodder. Cow ghee contains 20 to 25 units and buffalo may be an important source of calcium. Only 20 to 25% of dietary carotenes are absorbed depending upon the fat content of food. One microgram beta carotene is with iron and is required in very minute quantities, regarded as equivalent to 0. Fluorine prevents dental Recommended daily allowance is 600 mg retinol for an adult but 950 mg for a lactating mother. Vitam in D Vitamins It increases calcium and phosphate absorption from the intestine and helps in calcification of bones and teeth. Vitamins are organic compounds needed in minute amounts that are essential for health and well-being. Vitam in A • Ultraviolet light from sun irradiates a lipid substance It is essential for body growth and for the integrity of in the skin known as 7-dehydrocholesterol to form epithelial tissues. Clothes, glass Deficiency: Vitamin A deficiency is widely prevalent in and fog obstruct ultraviolet light and interfere with India. Calciferol is the most common synthetic preparation • Keratomalacia, xerophthalmia and Bitot’s spots. Margarine and vanaspati are routinely enriched • Drying and roughness of skin and drying of mucous with synthetic vitamins A and D. Fish liver oils are very situations associated with minimal exposure to sun, rich in vitamin A. Excess of vitamin (provitamin A), are converted into vitamin A in the D is toxic and causes calcification of tissues. Leafy vegetables such as spinach, cabbage, lettuce, curry and radish leaves; yellow pumpkin; and Vitam in E fruits such as mangoes, papaya, tomatoes and oranges are rich in carotene.
Myxir, 64 years: Hyperparathyroidism postoperative period, magnesium defciency The total amount of calcium in the body is 3.
Topork, 57 years: When the vegetations erode into myocardium, they can form an abscess called Ring abscess.
Renwik, 54 years: Bile acids are potentially toxic to cells, and their concentrations are tightly regulated.