You must be able to tell these apart!!! Do NOT get these confused.

Because the natural history of gallstones is generally benign, cholecystectomy is not required for patients with asymptomatic gallstones. –However, cholecystectomy for asymptomatic gallstones may be indicated under certain circumstances: Patients with large gallstones greater than 2 cm in diameter Patients with nonfunctional or calcified (porcelain) gallbladder observed on imaging studies and who are at high [...]

Thrombosis of the splenic vein is a rare, but important, cause of variceal bleeding. The blood, blocked from its usual route, flows through the gastric veins (in the stomach), continuing towards the liver. Large gastric varices, seen on EGD, develop as the blood traverses the stomach; later, these may rupture and bleed.  Esophageal varices do not occur because the [...]

Achalasia is a disorder of the esophagus that is characterized by: Episodic spasms that can mimic cardiac pain due to disorganized peristalsis.  There is elevated lower esophageal sphincter (LES) pressure. There is dysfunctional LES relaxation. The symptoms show difficulty swallowing solids and liquids with associated regurgutation while supine or asleep. The symptoms develop insidiously over [...]

History The classic clinical presentation of Boerhaave syndrome usually consists of repeated episodes of retching and vomiting, typically in a middle-aged man with recent excessive dietary and alcohol intake. These repeated episodes of retching and vomiting are followed by a sudden onset of severe chest pain in the lower thorax and the upper abdomen. The [...]

Infection Source Clinical Features Alaria americana Undercooked frog legs Disseminated fatal thoracic, gastrointestinal, retroperitoneal, and CNS manifestations; intraocular infections Echinostomiasis (16 species) Freshwater fish, aquatic plants, clams, snails, mollusks, contact with aquatic birds May be asymptomatic; mild abdominal pain, bloating, dyspepsia, diarrhea, eosinophilia Fibricola species Tadpoles Abdominal pain, diarrhea, fever, eosinophilia Fasciolopsis species Water chestnut, [...]

Hepatocellular carcinoma (HCC) is a primary malignancy of the liver. Hepatocellular carcinoma is now the third leading cause of cancer deaths worldwide, with over 500,000 people affected.  The incidence of hepatocellular carcinoma is highest in Asia and Africa, where the endemic high prevalence of hepatitis B and hepatitis C strongly predisposes to the development of [...]

Patients with porcelain gallbladder are usually asymptomatic, and the condition is usually found incidentally on plain abdominal radiographs, sonograms, or computed tomography (CT) images. Surgical treatment of porcelain gallbladder is based on results from studies performed in 1931 and 1962, which revealed an association between porcelain gallbladder and gallbladder carcinoma. Porcelain gallbladder is an uncommon [...]

Rare disorder with arthralgia, abdominal pain, diarrhea, progressive weight loss, dilated lacteals in the bowel wall, and impaired intestinal absorption Demonstration of macrophages containing large cytoplasmic granulas that are PAS-positive in mucosa (virtually replacing most other cellular elements) is diagnostic. Electron microscopy has revealed presence of rod-shaped structures identified as Tropheryma whippelii. Therapy with antibiotics [...]

Chronic disorder with continuing hepatocellular necrosis and inflammation, usually with fibrosis and tendency to progress to cirrhosis and liver failure There is cell-mediated immunologic attack on liver cells. Humoral immunity plays a role in extrahepatic manifestations (arthralgias, cutaneous vasculitis, and glomerulonephritis). Clinical features are very similar to those of chronic viral hepatitis. Laboratory, besides LFT-s, [...]

Usual presentation is a male in his 50′s with itching and fatigue. Idiopathic, progressive, inflammatory, sclerosing, and obliterative process affecting extrahepatic and often intrahepatic bile ducts. Very high alkaline phosphatase compared to AST and ALT. High Copper levels (like PBS & Wilsons). P-ANCA positive Associated with inflammatory bowel diseases (usually Ulcerative Colitis) and multifocal fibrosclerosis [...]

Diagnostic criteria for irritable bowel syndrome: At least 3 months of continuous or recurrent symptoms of abdominal pain or discomfort that is (a) Relieved by defecation (b) Associated with change in frequency or (c) Consistency of stool; and Two or more of the following (no less than ¼ of days): (a) Altered stool frequency (<3 [...]

Peak incidence in 15-35 years of age Symptoms and features include diarrhea, abdominal pain, weight loss, skipped lesions, transmural involvement, spares rectum, perirectal disease (common), fistula formation, cholesterol gallstones, Ca+ Oxalate kidney stones, increased colon cancer incidence, and joint pains. Erythema Nodosum**** parallels bowel disease Sigmoidoscopy and radiologic studies are most important for diagnostic evaluation. [...]

Benign disorder with mild, persistent, unconjugated hyperbilirubinemia and jaundice which fluctuates Exacerbated by fasting, surgery, fever, or infection and excessive exertion and alcohol ingestion Increased bilirubin and NORMAL liver function tests Mildest of the three conditions characterized by deficiency of glucuronosyltransferase (more serious is Crigler-Najjar sy. type II and really bad is Crigler-Najjar sy. Type [...]

Also known as GLUTEN-SENSITIVE ENTEROPATHY (or non-tropical spue) it is characterized by general malabsorption due to a reaction of gluten to the mucosa of the small intestine. Prevalent in Ireland Causes growth retardation Associated with HLA-DQ2 & HLA-DQ8 Symptoms are highly variable in severity ranging from mild (anemia or osteomalacia) to severe (adenocortical deficiency, abdominal pain, dehydration [...]

Vit B1********Wernickes/Korsakoff Vit B2********glossitis, cheilosis, stomatitis, perineal dermatitis Vit B6********seizures, cheilosis, glossitis Vit B12*******megaloblastic anemia Vit C**********scurvy (hemorrhages/ecchymoses) Vit A**********blindness (night blindness first) Vit D**********rickets & osteomalacia Vit E**********areflexia, decreased vibratory or position-sense Niacin********sun-exposed dermatitis, diarrhea, and dementia

Caused by chronic gastro-esophageal reflux usually of a long duration (more than 10 years) Increased incidence of adenocarcinoma (almost 30 times the normal risk) Pharmacological treatment does not reverse the process. Screen the patient with EGD and biopsies every 1-2 years until dysplasia occurs.  Actually the grade of dysplasia determines the interval for surveillance endoscopy. In [...]

Ascites in the presence of normal liver function Low grade fever High protein ascitic fluid Diagnose by peritoneal biopsy in association with a positive PPD

Classic triad of gastric acid hypersecretion, duodenal ulcer, and pancreatic islet cell tumor Symptoms: diarrhea, recurrent ulcers. The gastrinoma causes G.I. hypersecretion. MEN I (Hypercalcemia secondary to hyperparathyroidism) Enlarged gastric folds on EGD. Bi-temporal hemianopsia can occur secondary to a sella tursica mass lesion. Treatment: Proton pump inhibitors and/or other acid blockers

Disorder resulting in ceruloplasmin deficiency and copper accumulation in liver Clinical symptoms include jaundice, hepatomegaly, splenomegaly, nausea and vomiting, recurrent acute hepatitis with moderately high aminotransferase levels. Neurologic, kidney, and eye findings usually follow these symptoms. Keyser-Fleischer rings (corneal deposits)occur in 95% of adult patients!   Diagnose by measuring Ceruloplasmin levels (highly specific). Confirm with [...]

Women in their 50’s and 60’s Itching and fatigue are the most common specific symptoms of early disease. Approximately 70% of patients have hepatomegaly. Elevated Alkaline Phosphatase The best screening test for suspected primary biliary cirrhosis is the antimitochondrial antibody. It is positive in 95% of affected patients and has a 98% specificity. Hyperpigmentation and [...]