Benign Conditions of Liver MCQs

The factors that result in an increased recurrence and progression rate are: high grade; pT1 disease; concomitant CIS; multiple primary tumours; recurrent disease at the first check cystoscopy 3 months after diagnosis. Patients with known bladder tumours should always be screened for upper tract tumours. Very few present with advanced constitutional symptoms and a palpable mass. Microscopic haematuria should be evaluated to exclude urothelial malignancy in the high-risk adult (chronic smokers, occupational exposure, older age) population. Reference : Bailey & Love's Short Practice of Surgery 28 th Edition, Chapter 82, The Kidney and Ureter, Pg: 1481.

The most common situations requiring urgent or emergency surgery for the management of variceal bleeding are - Failure of acute endoscopic treatment Failure of long-term endoscopic therapy Hemorrhage from gastric varices or portal hypertensive gastropathy Failure of TIPS placement. Reference : Sabinston Textbook of Surgery 21st Edition, SECTION X ABDOMEN, Chapter 54, The Liver Pg: 1446.

The liver is probably exposed to portal venous bacterial loads on a regular basis and usually clears this bacterial load without problems. The development of a hepatic abscess occurs when an inoculum of bacteria, regardless of the route of exposure, exceeds the liver's ability to clear it. This results in tissue invasion, neutrophil infiltration, and formation of an organized abscess. The potential routes of hepatic exposure to bacteria are the biliary tree, portal vein, hepatic artery, direct extension of a nearby nidus of infection, and trauma. Reference : Sabiston Textbook of Surgery 21 st Edition, SECTION X ABDOMEN, Chapter 54, The Liver Pg: 1428

Most hepatic abscesses involve the right hemiliver, accounting for about 75% of cases. The explanation for this is not known, but preferential laminar blood flow to the right side has been postulated. The left liver is involved in approximately 20% of the cases; the caudate lobe is rarely involved (5%). Bilobar involvement with multiple abscesses is uncommon. Approximately 50% of hepatic abscesses are solitary. Hepatic abscesses can vary in size from less than 1 mm to 3 or 4 cm in diameter and can be multiloculated or a single cavity. At abdominal exploration, hepatic abscesses appear tan and are fluctuant to palpation, although deeper abscesses may not be visible and can be difficult to palpate. Surrounding inflammation can cause adhesions to local structures. Reference : Sabiston Textbook of Surgery 21st Edition, SECTION X ABDOMEN, Chapter 54, The Liver Pg: 1453