Yearly Archives: 2006

A bile duct is any of a number of long tube-like structures that carry bile. Bile, required for the digestion of food, is excreted by the liver into passages that carry bile toward the hepatic duct, which joins with the cystic duct (carrying bile to and from the gallbladder) to form the common bile duct, which opens into the intestine. The biliary tree (see below) is the whole network of various sized ducts branching through the liver. The path is as follows: Bile canaliculi → Canals of Hering → interlobular bile ducts → intrahepatic bile ducts → left and right hepatic ducts merge to form → common hepatic duct exits liver and joins → cystic duct (from gall bladder) forming → common bile duct → joins with pancreatic duct → forming ampulla of Vater → enters duodenum Common bile duct The top half of the common bile duct is associated with the liver, while the bottom half of the common bile duct is associated with the pancreas, through which it passes on its way to the intestine. It opens in the part of the intestine called the duodenum into a structure called the ampulla of Vater. Pathology Blockage of the bile duct by a cancer, gallstones, or scarring from injury prevents [...]

Belching, also known as burping, ructus, or eructation, involves the release of gas from the digestive tract (mainly esophagus and stomach) through the mouth. It is usually accompanied with a typical sound and, at times, an odor. Physiology Belching is typically caused by swallowing air (aerophagia) when eating or drinking and subsequently expelling it, so in this case the expelled gas is mainly a mixture of nitrogen and oxygen. Burps can also be caused by drinking carbonated drinks such as beer, soft drinks, or champagne, in which case the expelled gas is carbon dioxide from the drink itself. Common diabetes drugs metformin [1] and Byetta [2] can cause belching, especially at higher doses. This often resolves in a few weeks. Belching combined with other symptoms such as dyspepsia, nausea and heartburn may be a sign of an ulcer or hiatal hernia, and should be reviewed by a physician. [3] The sound of burping is caused by the vibration of the upper esophageal sphincter[4] as the gas passes through it. The current Guinness world record for the loudest burp is 118.1 dB, set by Paul Hunn from London, England in 2000.[5] (This would be noticeably louder than a chainsaw at a distance of 1 meter.) Social context and etiquette In many parts [...]

In medicine, gallstones (choleliths) are crystalline bodies formed within the body by accretion or concretion of normal or abnormal bile component. Gallstones can occur anywhere within the biliary tree, including the gallbladder and the common bile duct. Obstruction of the common bile duct is choledocholithiasis; obstruction of the biliary tree can cause jaundice; obstruction of the outlet of the pancreatic exocrine system can cause pancreatitis. Cholelithiasis is the presence of stones in the gallbladder—chole- means “bile”, lithia means “stone”, and -sis means “process”. The characteristics of gallstones are various. Independent of appearance, however, gallstones from animals are valuable on the market. Characteristics of Gallstone Size A gallstone’s size varies and may be as small as a sand grain or as large as a golf ball. The gallbladder may develop a single, often large, stone or many smaller ones. They may occur in any part of the biliary system. Content Gallstones Gallstones have different appearance, depending on their contents. On the basis of their contents, gallstones can be subdivided into the two following types: Cholesterol stones are usually green, but are sometimes white or yellow in color. They are made primarily of cholesterol. Pigment stones are small, dark stones made of bilirubin and calcium salts that are found in bile. They account [...]

Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrous scar tissue as well as regenerative nodules (lumps that occur as a result of a process in which damaged tissue is regenerated),[1][2][3] leading to progressive loss of liver function. Cirrhosis is most commonly caused by alcoholism and hepatitis C, but has many other possible causes. Ascites (fluid retention in the abdominal cavity) is the most common complication of cirrhosis and is associated with a poor quality of life, increased risk of infection, and a poor long-term outcome. Other potentially life-threatening complications are hepatic encephalopathy (confusion and coma) and bleeding from esophageal varices. Cirrhosis is generally irreversible once it occurs, and treatment generally focuses on preventing progression and complications. In advanced stages of cirrhosis the only option is a liver transplant. The word “cirrhosis” derives from Greek kirrhos, meaning “tawny” (the orange-yellow colour of the diseased liver). While the clinical entity was known before, it was René Laennec who gave it the name “cirrhosis” in his 1819 work in which he also describes the stethoscope.[4] Signs and symptoms of Cirrhosis Some of the following signs and symptoms may occur in the presence of cirrhosis or as a result of the complications of cirrhosis. Many are nonspecific [...]

Hepatitis (plural hepatitides) implies injury to the liver characterized by the presence of inflammatory cells in the tissue of the organ. The name is from ancient Greek hepar (ηπαρ) or hepato– (ηπατο-), meaning liver, and suffix -itis, meaning “inflammation” (c. 1727)[1]. The condition can be self-limiting, healing on its own, or can progress to scarring of the liver. Hepatitis is acute when it lasts less than six months and chronic when it persists longer. A group of viruses known as the hepatitis viruses cause most cases of liver damage worldwide. Hepatitis can also be due to toxins (notably alcohol), other infections or from autoimmune process. It may run a subclinical course when the affected person may not feel ill. The patient becomes unwell and symptomatic when the disease impairs liver functions that include, among other things, removal of harmful substances, regulation of blood composition, and production of bile to help digestion. Causes of Hepatitis Acute hepatitis Viral Hepatitis: Hepatitis A through E (more than 95% of viral cause), Herpes simplex, Cytomegalovirus, Epstein-Barr, yellow fever virus, adenoviruses. Non viral infection: toxoplasma, Leptospira, Q fever,[2] rocky mountain spotted fever[3] Alcohol Toxins: Amanita toxin in mushrooms, carbon tetrachloride, asafetida Drugs: Paracetamol, amoxycillin, antituberculosis medicines, minocycline and many others (see longer list below). Ischemic hepatitis [...]

An anal fissure is an unnatural crack or tear in the anus skin. As a fissure, these tiny tears may show as bright red rectal bleeding and cause severe periodic pain after defecation.[1] The tear usually extends from the anal opening and located posteriorly in the midline. This location is probably because of the relatively unsupported nature of the anal wall in that location. Causes of Anal fissure Most anal fissures are caused by stretching of the anal mucosa beyond its capability. Many acute anal fissures will heal spontaneously. Some fissures become chronic and will not heal. The most common cause for this is spasm of the internal anal sphincter muscle. This spasm causes poor blood flow to the anal mucosa, hence producing an ulcer which does not heal since it is deprived of normal blood supply. Anal fissures are common in women after childbirth[2], excessive anal intercourse, after difficult bowel movements and in infants following constipation.[3] Prevention for Anal fissure In infants under one year old, frequent nappy/diaper change can prevent anal fissure. For adults, the following can help prevent fissure: Treating constipation by eating food rich in dietary fiber, avoiding caffeine (which can increase constipation) ,[4] drinking a lot of water and taking stool softener. Treating diarrhea promptly. Lubricating [...]