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Hemobilia: Etiology, diagnosis, and treatment

Liver Research 2018年第4期2卷 200-208页

作者： Rani Berry James Han ani a.kardashian Nicholas F.LaRusso James H.Tabibian Department of Internal Medicine UCLA Ronald Reagan Medical CenterLos AngelesCAUSA Department of Internal Medicine University of California IrvineIrvineCAUSA UCLA Gastroenterology Fellowship Training Program Vatche and Tamar ManoukianDivision of Digestive DiseasesLos AngelesCAUSA Division of Gastroenterology and Hepatology Mayo ClinicRochesterMNUSA Division of Gastroenterology Department of MedicineOlive View-UCLA Medical CenterSylmarCAUSA

Hemobilia refers to bleeding from and/or into the biliary tract and is an uncommon but important cause of gastrointestinal *** of hemobilia date back to the 1600s,but due to its relative rarity and challenges in diagnosis,only in recent decades has hemobilia been more critically *** majority of cases of hemobilia are iatrogenic and caused by invasive procedures involving the liver,pancreas,bile ducts and/or the hepatopancreatobiliary vasculature,with trauma and malignancy rep-resenting the two other leading causes.A classic triad of right upper quadrant pain,jaundice,and overt upper gastrointestinal bleeding has been described(***'s triad),but this is present in only 25%e30%of patients with ***,prompt diagnosis depends critically on having a high index of suspicion,which may be based on a patient's clinical presentation and having recently undergone(peri-)biliary instrumentation or other predisposing *** treatment of hemobilia depends on its severity and suspected source and ranges from supportive care to advanced endoscopic,interventional radiologic,or surgical *** we provide a clinical overview and update regarding the eti-ology,diagnosis,and treatment of hemobilia geared for specialists and subspecialists alike.

关键词： Hemobilia Upper gastrointestinal hemmorhage Etiology Diagnosis Imaging Hepatopancreatobiliary interventions

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Preventative care in cholestatic liver disease: Pearls for the specialist and subspecialist

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Liver Research 2019年第2期3卷 118-127页

作者： Adnan Malik ani a.kardashian Kais Zakharia Christopher L.Bowlus James H.Tabibian Department of Public Health and Business Administration The University of Alabama at BirminghamBirminghamALUSA Department of Internal Medicine Beaumont HospitalDearbornMIUSA University of California Los Angeles Gastroenterology Fellowship Training Program Vatche and Tamar Manoukian Division of Digestive DiseasesLos AngelesCAUSA Division of Gastroenterology and Hepatology University of IowaIowaIAUSA Division of Gastroenterology and Hepatology University of California DavisSacramentoCAUSA Division of Gastroenterology Department of MedicineOlive View-University of California Los Angeles Medical CenterSylmarCAUSA

Cholestatic liver diseases(CLDs)encompass a variety of disorders of abnormal bile formation and/or *** often lead to progressive hepatic insult and injury and following the development of cirrhosis and associated *** such complications are clinically silent until they manifest with severe sequelae,including but not limited to life-altering symptoms,metabolic disturbances,cirrhosis,and hepatobiliary diseases as well as other *** sclerosing cholangitis(PSC)and primary biliary cholangitis(PBC)are the most common CLDs,and both relate to mutual as well as unique *** review provides an overview of PSC and PBC,with a focus on preventive measures aimed to reduce the incidence and severity of disease-related complications.

关键词： Biliary tract diseases Primary sclerosing cholangitis(PSC) Primary biliary cholangitis(PBC) Cirrhosis Inflammatory bowel disease(IBD) Metabolic bone disease Pruritus Prophylaxis

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