Rheumatologic disease and the liver.

Rheumatologic diseases such as rheumatoid arthritis, systemic lupus erythematosus, Sjögren syndrome, and scleroderma are immunologically mediated disorders that typically have multisystem involvement. Although clinically significant liver involvement is rare, liver enzyme abnormalities may be observed in up to 43% of patients. The biochemical abnormalities are typically mild and transient and the histologic abnormalities are usually nonprogressive.

Preoperative transjugular intrahepatic portosystemic shunt (TIPS) for cirrhotic patients undergoing abdominal and pelvic surgeries.

Background: Surgery for patients with cirrhosis is associated with increased morbidity and mortality. Perioperative complications including hemorrhage, wound dehiscence, and peritonitis result from underlying portal hypertension. Perioperative control of portal hypertension could decrease the risk of such complications.

Emerging infections of the gastrointestinal tract.

Infections account for significant GI morbidity and mortality worldwide. New organisms are being identified, associated with diarrhoeal illness and some with other gastrointestinal illness as well. Among GI viruses, Sapovirus is now recognised to cause diarrhoea, especially in children.

Endoscopic gallbladder stent placement for treatment of symptomatic cholelithiasis in patients with end-stage liver disease.

Objectives: Symptomatic cholelithiasis is a common disease in the general population with an increased prevalence in patients with cirrhosis. While cholecystectomy is the procedure of choice for the treatment of symptomatic cholelithiasis, cirrhotics have an increased risk of complications associated with this therapy. We have found that placement of an endoscopic gallbladder stent is an alternative, less invasive treatment for cirrhotic patients with symptomatic gallbladder disease and describe our experience here.