LIVER AND GB!!

the left lobe of liver is divided into medial and lateral segments by

left hepatic vein and ligamentum of teres

the left lobe of liver is seperated from caudate lobe by

ligamentum of venosum

what lies within falciform ligament and is previous fetal umbilical vein

ligamentum teres

alk phos elevation is associated with

obstructive jaundice

ALT elevation is associated with

cirrhosis, hepatitis, biliary obstruction

AST elevtion assocaited with

cirrhosis, hepatitis, mononucleosis

what are common causes of liver abscess

• ascending cholangitis (m/c)

• recent travel abroad

• infection

what is this

abscess

candidiasis is normally found with

immune-supressed patients

uniformly hypo lesions

wheel within wheel

candidiasis

what can cause echinococcal cyst

recent travel to underdeveloped countries

honeycomb appearance, daughter cysts, water lilly sign

echinoccocal cyst

normal-hypo liver parenchyma, prominent portal veins, hepatomegaly, splenomegaly

hepatitis

what is schistosomiasis caused by

parasite entering the skin and travelling to lung then liver

what is the main clinical findings of schistosomiasis

rash, fever, diarrhea, lymphadenopathy, RUQ pain

increase echogenicity of portal walls, thick gb wall

schistosomiasis

what is liver adenoma caused by mainly

• long history of oral contraceptive use

• type 1 glycogen storage disease

slightly hypo mass with a hypoechoic halo

adenoma

diffuse parenchymal echogenicity, irregular nodular contour, no portal wall distinguish, enlarged caudate lobe, splenomegaly, ascites

cirrhosis

hyperechoic/isoechoic, spoke wheel pattern with a central scar

FNH

glycogen storage disease type 1

von Gierke disease

diffuse increase echogenicity, solid liver masses (adenomas)

glycogen storage disease

m/c malignant tumour in children

liver hepatoblastoma

heterogenous, hyperechoic, cystic, internal spetations

heaptoblastoma

clinical of HCC

palp mass, abdo pain, weight loss, jaundice

elevated ALT, AST, alk phos

previous cirrhosis, chronic hep b

HCC

• variable echogenicity, hypo halo

what are common patterns for metastases

bulls eye/ target, hyperehchoic, cystsic, complex, diffuse

• weight loss, jaundice, increase AST, ALT, bilirubin

• mild increase alk phos

mets

budd chiari

thrombus within hepatic veins

sonographic findings for portal hypertension

• MPV exceeding 13mm, splenomegaly, ascites, collaterals

• RI exceeding 0.8 in hepatic arteries

• changes in portal venous flow

  • hepatofugal, pulsatile, decrease in velocity

TIPS

shunt placed behind portal vein and hepatic vein

• m/c right portal vein and right hepatic vein

m/c cause of cirrhosis

alcohol abuse

HCC has a ____ in serum albumin

decrease

hepatic abscess is most likely to develop in which condition

asceinding cholangitis

what separates the left lobe from right lobe

middle hepatic vein and main lobar fissure

pt presents with RUQ pain, fever, leukocytosis. Pt discloses recent travel abroad. Complex mass is seen in rt lobe of liver. this is most likely

hepatic abscess

pts with hep b have an increase risk for developing

cirrhosis and adenoma

daughter cysts are associated with

echinococcal cyst

normal blod flow pattern in MPV is

phasic, hepatopedal

what is related to oral contrceptives/hormone levels

adenoma and FNH

pt presents with hx of hep c and abdominal distention. This finding in the porta heptatits is most commonly associated with

portal hypertension

• heptofugal flow

what liver pathology is associated with immune suppresed patients

candidiasis

metastatic lesions involving liver m/c originate from

colon

what is cirrhosis

severe insult to the liver cells leading to subsequent necrosis

paraumbilical vein courses from umbilicus to the

left portal vein

hepatic veins demonstrate ____ flow

multiphasic

decrease in prothrombin time can be associated with

acute cholecystitis

caroli disease

• segmental, saccular, beaded appearance of intrahepatic ducts

• multiple cystic structures in liver that communicate with biliary tree

what is klatskin tumour

small echogenic mass near hepatic hilum, dilatation of intrahepatic ducts, normal extrahepatic ducts

choledochal cyst

cystic mass medial to the gallbladder and lateral to head of pancreas

mirizzi syndrome

immobile calc in cystic duct or neck of GB

main lobar fissure

gravity dependent low level echoes within bile duct

hemobilia

dilatation of the intrahepatic ducts with normal extraheptatic ducts is characteristic of

klatskin tumour