Ultrasonography Case Study

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presenting with hepatic decompensation necessitates urgent diagnostic evaluation (Cobbold et al., 2010).  Ultrasonography: Ultrasonography is viewed as a non-invasive and widely available method that allows assessment of biliary tree calibre, identifies features suggestive of cirrhosis and portal hypertension, and is of value for detecting focal lesions (Fox et al., 2011). In a series of 103 patients with liver cirrhosis, it has been demonstrated that liver parenchymal texture (graded as fine echo texture, mildly coarse, coarse, and highly coarse) has a statistically significant correlation with the degree of fibrosis (Nishiura et al., 2005). The assessment of hepatic vein morphology has been shown to be a good indicator of cirrhosis.…show more content…
 Liver biopsy: Faced with a negative screen, extra-hepatic diseases such as cardiac failure and inflammatory, infective and mitotic conditions should be considered. If diagnostic doubt persists, a percutaneous ultrasound-guided liver biopsy should be considered. It may clarify diagnosis, thereby directing therapy, and through staging (assessment of fibrosis). It is often overlooked in the older population due to safety concerns. However, complications are rare and mortality is age independent at approximately 0.2% (Fox et al., 2011).  Other methods: Novel, non-invasive methods of assessing fibrosis, particularly the Fibro Scan (transient elastography) technique are gaining favor, though validation data are lacking in certain situations and availability is variable. This may ultimately reduce the need for biopsy (Castera et al., 2008). Severity assessment of chronic liver…show more content…
Upgraded NO release has additionally been detected in splanchnic vasculature of patients with cirrhosis. In cardiac tissue, significantly higher TNF-α, cGMP and iNOS levels were reported in cardiac homogenates obtained from cirrhotic rats, indicating a possible cytokine - iNOS – cGMP mediated pathway in the pathogenesis of CCM. The same study analyzed further the NO-associated effects on cardiac contractility in isolated left ventricular papillary muscles in response to treatment with the nonspecific NOS inhibitor nitro-L-arginine methyl ester (LNAME) (Gassanov et al.,

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