Manual of Gastroenterology: Diagnosis and Therapy

528 Pages·2008·3.567 MB·English

by  Canan Avunduk

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MANUAL OF GASTROENTEROLOGY:
DIAGNOSIS AND THERAPY
Fourth Edition
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MANUAL OF GASTROENTEROLOGY:
DIAGNOSIS AND THERAPY
Fourth Edition
Canan Avunduk, M.D., Ph.D.
Bay State Gastroenterology
Melrose, Massachusetts;
Clinical Associate Professor of Medicine
Tufts University Medical School
Boston, Massachusetts
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Library of Congress Cataloging-in-Publication Data
Avunduk, Canan.
Manual of gastroenterology: diagnosis and therapy/Canan Avunduk.—4th ed.
p. ; cm.
Includes bibliographical references and index.
ISBN-13: 978-0-7817-6974-7 (pbk. : alk. Paper) 1. Gastrointestinal system—
ISBN-10: 0-7817-6974-4
Diseases—Handbooks, manuals, etc. I. Title.
[DNLM: 1. Gastrointestinal Diseases—diagnosis—Handbooks. 2. Gastrointestinal
Diseases—therapy—Handbooks. WI 39 A963m 2008]
RC801.E26 2008
616.3'3—dc22
2007028861
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To all my teachers and students.
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CONTENTS
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
I. APPROACH TO THE PATIENT WITH A
GASTROENTEROLOGIC DISORDER
1. Social Impact of Digestive Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
2. The Patient’s Complaints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
3. Examination of the Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
4. Psychological and Emotional Aspects
of Gastroenterologic Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
II. DIAGNOSTIC AND THERAPEUTIC PROCEDURES
5. Endoscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
6. Laparoscopy and Laparoscopic Surgery . . . . . . . . . . . . . . . . . . . . . . . . 25
7. Percutaneous Liver Biopsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
8. Manometric Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
9. Imaging Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
III. NUTRITIONAL ASSESSMENT AND MANAGEMENT
10. Nutritional Requirements and Assessment . . . . . . . . . . . . . . . . . . . . . . 45
11. Enteral Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
12. Parenteral Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
IV. GASTROENTEROLOGIC EMERGENCIES
13. The Acute Abdomen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
14. Acute Gastrointestinal Bleeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
15. Foreign Bodies in the Gastrointestinal Tract . . . . . . . . . . . . . . . . . . . . . 94
VII
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VIII Contents
16. Caustic Ingestion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
17. Fulminant Hepatic Failure and Encephalopathy . . . . . . . . . . . . . . . . . . . 102
18. Gastrointestinal and Hepatobiliary Diseases in Pregnancy . . . . . . . . . . 111
V. SPECIFIC COMPLAINTS AND DISORDERS
19. Esophageal Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
20. Gastroesophageal Reflux Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
21. Dysphagia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
22. Noncardiac Chest Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
23. Esophageal Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
24. Peptic Ulcer Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
25. Stress Ulcer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
26. Helicobacter Pylori . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
27. Gastric Neoplasms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
28. Postgastrectomy Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
29. Diarrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
30. Viral, Bacterial, and Parasitic Disorders of the Bowel . . . . . . . . . . . . . . 195
31. Malabsorption . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
32. Small-Intestinal Neoplasms and Carcinoid Tumors . . . . . . . . . . . . . . . . 222
33. Irritable Bowel Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227
34. Intestinal Gas and Bloating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232
35. Diverticular Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236
36. Constipation and Fecal Impaction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240
37. Inflammatory Bowel Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 244
38. Vascular Disease of the Bowel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263
39. Colonic Polyps and Colorectal Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . 269
40. Ostomy Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 280
41. Hemorrhoids and Other Anorectal Disorders . . . . . . . . . . . . . . . . . . . . . 283
42. Sexually Transmitted Enteric Disorders . . . . . . . . . . . . . . . . . . . . . . . . . 288
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Contents IX
43. Gastrointestinal and Hepatobiliary Diseases
in Patients with HIV and AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292
44. Occult Obscure Gastrointestinal Bleeding . . . . . . . . . . . . . . . . . . . . . . . 303
45. Acute Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 306
46. Chronic Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317
47. Pancreatic Cancer, Ampullary Cancer, Cystic Tumors, and
Neuroendocrine Tumors of the Pancreas . . . . . . . . . . . . . . . . . . . . . . . . 326
48. Jaundice and Interpretation of Laboratory Liver Tests . . . . . . . . . . . . . 335
49. Gallstones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 349
50. Viral Hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 359
51. Alcoholic Liver Disease (ALD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 386
52. Nonalcoholic Fatty Liver Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 395
53. Drug-Related Hepatic Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 399
54. Chronic Immune-Mediated Liver Disease . . . . . . . . . . . . . . . . . . . . . . . . 407
55. Inherited Liver Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 421
56. Cirrhosis and Its Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 438
57. Tumors of the Liver and Biliary System . . . . . . . . . . . . . . . . . . . . . . . . . 455
58. Liver Transplantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 459
59. Anorexia Nervosa and Bulimia Nervosa . . . . . . . . . . . . . . . . . . . . . . . . . 473
60. Obesity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 476
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 484
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