فحوصات

    Cards (10)

    • Endoscopic sphincterotomy
      1. Place the sphincter muscle with the endoscope
      2. A guidewire is placed via the channel of the endoscope through the sphincter and pushed past the stricture using fluoroscopy to monitor progress
    • Placement of endoprosthesis (plastic stent)
      Following dilatation of the stricture, the endoprosthesis (plastic stent) is pushed over the guidewire and sited with its side-holes above and below the stricture
    • Metal biliary stents can also be placed at ERCP when appropriate
    • Aftercare
      1. As for percutaneous transhepatic cholangiography
      2. Antibiotics for at least 3 days
      3. An externally draining catheter should be regularly flushed through with normal Saline and exchanged at 3-monthly intervals
    • Complications
      • Sepsis-particularly common with long-term, externally draining catheters
      • Dislodgement of catheters, endoprostheses
      • Blockage of catheters/endoprostheses
      • Perforation of bile duct above the stricture on the passage of guidewire
    • محاضرة (ح)
      Ultrasound of the liver
    • الموجات فوق الصوتية للكبد
      Ultrasound of the liver
    • Indications
      • Suspected focal or diffuse liver lesion
      • Jaundice
      • Abnormal liver function tests
      • Right upper-quadrant pain or mass
      • Hepatomegaly
      • Suspected portal hypertension
      • Staging known extrahepatic malignancy, superseded by CT
      • Pyrexia of unknown origin, now superseded by CT for patients over 30 years old
      • To provide real-time image guidance for the safe placement of needles for biopsy
      • Assessment of portal vein, hepatic artery or hepatic veins
      • Assessment of patients with surgical shunts or transjugular intrahepatic portosystemic shunt (TIPS) procedures
      • Follow-up after surgical resection or liver transplant
    • Contraindications: None
    • Patient Preparation
      Fasting or restriction to clear fluids only required if the gallbladder is also to be Studied
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