Download Key Facts in Gastroenterology by Jonathan Halevy PDF
By Jonathan Halevy
This e-book is a unprecedented success by means of Jonathan Halevy. To condense the fabric of 3 significant gastrointestinal textbooks will be triumph adequate, yet so as to add a distillate of the contents of ten journals, from 1980 to 1985, calls for Herculean vigour. To reorganize all of the fabric below headings which extract concise "facts" from wheat and chaff calls for a passionate curiosity in pa tients including an knowing of body structure. thankfully, Jonathan Halevy has simply the correct mix of medical and lab oratory curiosity for him to choose the main points of what's vital. Such compulsive commitment has now made it attainable for the prac ticing health practitioner, gastroenterologist, or condo officer, drawn to getting ready for board examinations or just searching within the box, to have at his fingertips a sequence of definitions and to install his pocket the major proof for prognosis and treatment. after all, evidence through themselves are anything of which to be a bit cautious. Scientists first, medical professionals regard evidence the way in which farmers examine sheep-to be sheared for his or her software. medication too usually is just a fact-gathering career (some lectures ship me to wool gathering), during which having the evidence occasionally clouds scientific judgment approximately what's very important for the person sufferer. - vii viii FOREWORD tionalism and romanticism lie on the poles of clinical perform, yet rationalism ideas within the 1980s.
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Diverticulitis and ulcerative colitis rarely coexist in the same patient. 97. " 98. Management of diverticulitis includes (a) bed rest; (b) NPO (nasogastric tube if ileus is present); and (c) administration of antibiotic agents only if fever, ileus, or signs of pericolic abscess are present. 99. In diverticulitis 70-80% of patients respond to conservative 93 THE SMALL AND LARGE INTESTINE 53 treatment, and two-thirds of these patients will not have another attack requiring hospitalization. In 15-30% of patients with diverticulitis, surgery will be required.
GU in the fundus of the stomach is uncommon and is usually related to aspirin. 152. The lack of gastritis in the vicinity of GU points to an association with aspirin. 153. Antral GU tends to be smaller than GU in other regions of the stomach. 154. On the average, gastric secretion is decreased in GU, but most patients have normal gastric secretion. Similarly, serum gastrin levels are elevated, but its measurement is not indicated unless Z-E is suspected. 155. In GU, the more associated gastritis, the less gastric secretion.
Resection of up to 40% of the small bowel is usually well tolerated if the duodenum, the proximal jejunum, the distal half of the ileum, 52 46 CHAPTER 3 and the ileocecal valve are spared. Resection of 50% or more of the small bowel usually results in malabsorption. Resection of 70% is life threatening. Preservation of the ileocecal valve is important because it prolongs transit time and prevents bacterial overgrowth in the small intestine. 53. Gastrin hypersecretion is present in 50% of patients after extensive small bowel resection and may lead to peptic ulcer disease.