Fatty Liver (Steatohepatitis) Fatty liver is caused by the accumulation of fats in and around the hepatic cells. Causes include: Diabetes mellitus Obesity Elevated lipid profile Many clients are asymptomatic
Hepatic Abscess Liver invaded by bacteria or protozoa causing abscess Pyrogenic liver abscess; amebic hepatic abscess Treatment usually involves: Drainage with ultrasound guidance Antibiotic therapy
Liver Trauma The liver is the most common organ injured in clients with penetrating trauma of the abdomen, such as gunshot wounds and stab wounds. Clinical manifestations include abdominal tenderness, distention, guarding, rigidity. Treatment involves surgery, multiple blood products.
Cirrhosis Cirrhosis is extensive scarring of the liver, usually caused by a chronic irreversible reaction to hepatic inflammation and necrosis. Complications depend on the amount of damage sustained by the liver. In compensated cirrhosis, liver has significant scarring but performs essential functions without causing significant symptoms.
Liver Transplantation Used in the treatment of end-stage liver disease, primary malignant neoplasm of the liver Donor livers obtained primarily from trauma victims who have not had liver damage Donor liver transported to the surgery center in a cooled saline solution that preserves the organ for up to 8 hours
Acute Cholecystitis Acute cholecystitis is the inflammation of the gallbladder. Cholelithiasis (gallstones) usually accompanies cholecystitis. Acalculous cholecystitis inflammation can occur in the absence of gallstones. Calculous cholecystitis is the obstruction of the cystic duct by a stone, which creates an inflammatory response.
Chronic Cholecystitis Repeated episodes of cystic duct obstruction result in chronic inflammation Pancreatitis, cholangitis Jaundice Icterus Obstructive jaundice Pruritus
Surgical Management Laparoscopic cholecystectomy Standard preoperative care Operative procedure Postoperative care Free air pain result of carbon dioxide retention in the abdomen Ambulation Return to activities in 1 to 3 weeks
Traditional Cholecystectomy Standard preoperative care Operative procedure Postoperative care Meperidine hydrochloride via patient-controlled analgesia pump Antiemetics Wound care Care of the T-tube Nothing by mouth Diet therapy
Cancer of the Gallbladder Anorexia, weight loss, nausea, vomiting, general malaise, jaundice, hepatosplenomegaly, chronic, progressively severe epigastric or right upper quadrant pain Poor prognosis Surgery, radiation, chemotherapy
Acute Pancreatitis Serious and possibly life-threatening inflammatory process of the pancreas Necrotizing hemorrhagic pancreatitis Lipolysis Proteolysis Necrosis of blood vessels Inflammation Theories of enzyme activation
Chronic Pancreatitis Progressive destructive disease of the pancreas, characterized by remissions and exacerbations Nonsurgical management includes: Drug therapy Analgesic administration Enzyme replacement Insulin therapy Diet therapy
Pancreatic Abscess Most serious complication of pancreatitis; always fatal if untreated High fever Blood cultures Drainage via the percutaneous method or laparoscopy Antibiotic treatment alone does not resolve abscess