Sandbox:Dildar: Difference between revisions
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{{CMG}}; {{AE}} {{SH}} | {{CMG}}; {{AE}} {{SH}} | ||
== | <small> | ||
{| class="wikitable" style="border: 0px; font-size: 90%; margin: 5px;" align="center" | |||
! colspan="3" | | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease | ||
| colspan="13" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Clinical manifestations''' | |||
! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Diagnosis | |||
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Comments | |||
|- | |- | ||
| colspan="9" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Symptoms''' | |||
! colspan="4" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Signs | |||
! | |||
|- | |- | ||
| | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain | ||
| | ! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Fever | ||
| | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Rigors and chills | ||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Nausea or vomiting | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Jaundice | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |GI bleeding | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo- | |||
tension | |||
! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Guarding | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Rebound Tenderness | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bowel sounds | |||
! colspan="1" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" | Lab Findings | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatocellular carcinoma]]/[[Metastasis]] | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* Normal | |||
* Hyperactive if obstruction present | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* High levels of [[Alpha-fetoprotein|AFP]] in serum | |||
* Abnormal [[Liver function test|liver function tests]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* US | |||
* CT | |||
* Liver biopsy | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
Other symptoms: | |||
* [[Splenomegaly]] | |||
* [[Variceal bleeding]] | |||
* [[Ascites]] | |||
* [[Spider nevi]] | |||
* [[Asterixis]] | |||
|- | |- | ||
|' | | colspan="1" rowspan="1" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cholangiocarcinoma]] | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Epigastric]] | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ± | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ± | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |− | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |N | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* Increased [[amylase]] / [[lipase]] | |||
* Increased stool fat content | |||
* Pancreatic function test | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |CT scan | |||
* Calcification | |||
* Pseudocyst | |||
* Dilation of main pancreatic duct | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* Predisposes to pancreatic cancer | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Pancreatic carcinoma]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Epigastric]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |− | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |N | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* ↑ [[Alkaline phosphatase]] | |||
* ↑ [[Bilirubin|serum bilirubin]] | |||
* ↑ [[gamma-glutamyl transpeptidase]] | |||
* ↑ [[CA 19-9]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* [[Computed tomography|MDCT]] with [[Positron emission tomography|PET]]/[[Computed tomography|CT]] | |||
* MRI | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
[[Skin]] manifestations may include: | |||
* [[Bullous pemphigoid]] | |||
* [[Mucous membrane pemphigoid|Cicatricial pemphigoid]] | |||
* [[Thrombophlebitis|Migratory superficial thrombophlebitis]] (classic [[Trousseau's syndrome]]) | |||
* [[Panniculitis|Pancreatic panniculitis]] | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Focal nodular hyperplasia]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ± | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ± | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Normal or hyperactive | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* [[Anti-neutrophil cytoplasmic antibody]] ([[P-ANCA]]) in [[Ulcerative colitis]] | |||
* [[Anti saccharomyces cerevisiae antibodies]] (ASCA) in [[Crohn's disease]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* [[String sign]] on [[abdominal x-ray]] in [[Crohn's disease]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
Extra intestinal findings: | |||
* [[Uveitis]] | |||
* [[Arthritis]] | |||
|- | |- | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Abdominal Pain | ||
! | ! style="background:#4479BA; color: #FFFFFF;" align="center" |Fever | ||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Rigors and chills | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Nausea or vomiting | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Jaundice | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Constipation | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Diarrhea | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Weight loss | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |GI bleeding | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Hypo- | |||
tension | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Guarding | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Rebound Tenderness | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Bowel sounds | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Lab Findings | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |Comments | |||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Gallbladder cancer]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffuse | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ± | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ± | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ± | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |N | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* [[Thrombocytopenia]] | |||
* [[Hypoalbuminemia]] | |||
* [[Small intestinal]] [[biopsy]] for [[Tropheryma whipplei]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |[[Whipple's disease other diagnostic studies|Endoscopy]] is used to confirm diagnosis. | |||
Images used to find complications | |||
*[[Whipple's disease x ray|Chest and joint x-ray]] | |||
*[[Whipple's disease CT|CT]] | |||
*[[Whipple's disease MRI|MRI]] | |||
*[[Whipple's disease ultrasound|Echocardiography]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Extra intestinal findings: | |||
* [[Uveitis]] | |||
* [[Endocarditis]] | |||
* [[Encephalitis]] | |||
* [[Dementia]] | |||
* [[Hepatosplenomegaly]] | |||
* [[Arthritis]] | |||
* [[Ascites]] | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Liver hemangioma]] | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]] | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in Hep A and E | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in fulminant hepatitis | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | Positive in acute | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |N | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* Abnormal LFTs | |||
* Viral serology | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* US | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* Hep A and E have fecal-oral route of transmission | |||
* Hep B and C transmits via blood transfusion and sexual contact. | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Liver abscess]] | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |RUQ | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ± | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | ± | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |Normal or hypoactive | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* CBC | |||
* Blood cultures | |||
* Abnormal [[Liver function test|liver function tests]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* US | |||
* CT | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cirrhosis|Cirrhosis]] | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]] | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |N | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* [[Hypoalbuminemia]] | |||
* Prolonged PT | |||
* Abnormal LFTs | |||
* [[Hyponatremia]] | |||
* [[Thrombocytopenia]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |US | |||
* Nodular, shrunken liver | |||
* [[Ascites]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* Stigmata of liver disease | |||
* Cruveilhier- Baumgarten murmur | |||
|- style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
|- | |- | ||
| | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Inflammatory lesions | ||
|[[ | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[RUQ]] | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | ||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki> | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="center" | − | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |N | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* [[Hypoalbuminemia]] | |||
* Prolonged PT | |||
* Abnormal LFTs | |||
* [[Hyponatremia]] | |||
* [[Thrombocytopenia]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |US | |||
* Nodular, shrunken liver | |||
* [[Ascites]] | |||
| style="padding: 5px 5px; background: #F5F5F5;" align="left" | | |||
* Stigmata of liver disease | |||
* Cruveilhier- Baumgarten murmur | |||
|- | |- | ||
|} | |} | ||
<small> | |||
==Classification== | ==Classification== | ||
Revision as of 18:30, 31 January 2018
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dildar Hussain, MBBS [2]
Disease | Clinical manifestations | Diagnosis | Comments | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Symptoms | Signs | |||||||||||||||
Abdominal Pain | Fever | Rigors and chills | Nausea or vomiting | Jaundice | Constipation | Diarrhea | Weight loss | GI bleeding | Hypo-
tension |
Guarding | Rebound Tenderness | Bowel sounds | Lab Findings | Imaging | ||
Hepatocellular carcinoma/Metastasis | RUQ | + | − | − | + | − | − | + | − | − | − | − |
|
|
|
Other symptoms: |
Cholangiocarcinoma | Epigastric | − | − | ± | ± | − | + | + | − | − | − | − | N | CT scan
|
| |
Pancreatic carcinoma | Epigastric | − | − | + | + | − | + | + | − | − | − | − | N |
Skin manifestations may include: | ||
Focal nodular hyperplasia | Diffuse | ± | − | − | ± | − | + | + | + | − | − | − | Normal or hyperactive |
Extra intestinal findings: | ||
Disease | Abdominal Pain | Fever | Rigors and chills | Nausea or vomiting | Jaundice | Constipation | Diarrhea | Weight loss | GI bleeding | Hypo-
tension |
Guarding | Rebound Tenderness | Bowel sounds | Lab Findings | Imaging | Comments |
Gallbladder cancer | Diffuse | ± | − | − | ± | − | + | + | − | ± | − | − | N | Endoscopy is used to confirm diagnosis.
Images used to find complications |
Extra intestinal findings: | |
Liver hemangioma | RUQ | + | − | + | + | − | Positive in Hep A and E | + | − | Positive in fulminant hepatitis | Positive in acute | + | N |
|
|
|
Liver abscess | RUQ | + | + | + | + | − | ± | + | − | + | + | ± | Normal or hypoactive |
|
|
|
Cirrhosis | RUQ | − | − | − | + | − | − | + | + | + | − | − | N |
|
US
|
|
Inflammatory lesions | RUQ | − | − | − | + | − | − | + | + | + | − | − | N |
|
US
|
|
Classification
Historical Perspective
Pathophysiology
Causes
Common casuses
The most common Cause of the splenic rupture remains blunt trauma to the abdomen.The other common causes of splenic rupture includes.[1]
- Neoplasms
- Infections
- Non Infectious
- Therapy related
- Mechanical Causes
Less common causes
The less common causes of splenic rupture are difficult to diagnose and can be threatening. Some less common causes of splenic rupture are as follows:
- Autologus stem cell transplantation in AL Amyloidosis patients[2]
Differentiating Splenic Rupture from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-Ray
MRI
Other Imaging Findings
Other Diagnostic Studies
Algorithms
Major molecular events in the pathogenesis of HCC | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Genomic alterations | Epigenetic modifications | Growthfactor pathway alterations | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Gene Mutations | Gene Amplification | DNA methylation micro RNA | Micro RNA | LNC RNA | Major Signaling pathways | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
•TERT promoter •TP53 •CTNNB1 •AXIN1 •AXIN2 •ATM •RPS6KA3 •JAK1 •IL6R •IL6ST •ARID1 •ARID2 | •CCND1 •FGF19 •CDKNA2A •CDKNA2B •AXIN1 •IRF2 •MET | GSTP1 •E-Cadherin •CDKNA2 •RASSF1A •SOCS-3 •MIGMT | •MiR-155 •Mir-122 •Mir-224 •Mir-21 | •HULC •HEIH •Dreh •MVIH •HOTAIR •MDIG •LINE1 | •Wnt/β –catenin •Tyrosine kinase pathways EGF HGF/c-MET FGF VEGF •IGF •HIF •TGF β •Hedgehog | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
The incidence of HCC has almost tripled since the early 1980s in the United States where it is the fastest rising cause of cancer-related deaths1. According to population based Surveillance Epidemiology and End Results registry data, the overall HCC age adjusted incidence rates for liver and intrahepatic ducts cancer is as high as 8 per 100,000 underling population in 2010 (Fig. 1) of which at least 6 per 100,000 related to HCC. Men are at approximately three times higher risk than women. Asian men (i.e., Chinese, Korean, Filipino, and Japanese) have the highest age-adjusted incidence rates. However, the largest proportional increases have occurred among Hispanics followed by blacks and non-Hispanic whites, whereas the lowest proportional increases have occurred among Asians. In contrast to Asians/Pacific Islanders, HCC incidence rates are reported to be higher among Hispanics born in the United States than among foreign-born Hispanics2. HCC incidence rates have increased in each successive birth cohort born between 1900 and 19593 (Fig. 2). In addition, the age distribution of HCC patients has shifted to younger ages, with the greatest proportional increases among individuals 45–60 years old (Fig. 2). There is a south to north gradient in the incidence and mortality of HCC; Southern states including Texas, Louisiana, and Mississippi have some of the highest HCC incidence rates in the nation (Fig. 3). In one study, Texas Latino and especially South Texas Latinos had the highest age-adjusted HCC incidence rates (as high as 10.6/100,000)4.
References
- ↑ Renzulli P, Hostettler A, Schoepfer AM, Gloor B, Candinas D (2009). "Systematic review of atraumatic splenic rupture". Br J Surg. 96 (10): 1114–21. doi:10.1002/bjs.6737. PMID 19787754.
- ↑ Sato S, Tamai Y, Okada S, Kannbe E, Takeda K, Tanaka E (2017). "Atraumatic Splenic Rupture due to Ectopic Extramedullary Hematopoiesis after Autologous Stem Cell Transplantation in a Patient with AL Amyloidosis". Intern Med. doi:10.2169/internalmedicine.9018-17. PMID 29093392.
- ↑ "File:Jaundice08.jpg - Wikimedia Commons". External link in
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