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Related Concept Videos

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow01:26

Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

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Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
248
Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment01:08

Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment

281
Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
281
Hepatic Portal System01:21

Hepatic Portal System

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The hepatic portal system, a critical part of our circulatory framework, transports nutrient-laden, deoxygenated blood from the gastrointestinal tract and spleen to the liver. This ingenious system plays an indispensable role in maintaining our body's metabolic equilibrium.
At its core, the hepatic portal vein is the result of a confluence of the superior and inferior mesenteric veins along with the splenic vein. Each of these veins has a unique role. The superior mesenteric vein is...
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Acute Pharyngitis01:30

Acute Pharyngitis

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Introduction
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
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Hepatic Drug Excretion: Influencing Factors01:16

Hepatic Drug Excretion: Influencing Factors

597
The biliary system of the liver, crucial for bile secretion and drug excretion, comprises intrahepatic bile ducts that merge to form the common hepatic duct. This duct, carrying hepatic bile, combines with the cystic duct, draining the gallbladder and forming the common bile duct, which empties into the duodenum. Bile, produced by hepatic cells lining the bile canaliculi, is composed primarily of water, bile salts, pigments, electrolytes, and lesser amounts of cholesterol and fatty acids. Bile...
597
Hepatic Drug Clearance: Role of Transporters01:14

Hepatic Drug Clearance: Role of Transporters

311
In the liver and bile canaliculi, influx and efflux transporters modification can influence intrinsic clearance. Transporters play a significant role in moving drugs within liver cells. Elaborate models, such as the Biopharmaceutical Classification System (BCS), are essential to relate transporters to drug disposition. This system categorizes drugs into four classes based on solubility and permeability, providing insights into elimination routes and the effects of transporters following oral...
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Related Experiment Videos

Nephroblastoma presenting with acute hepatic encephalopathy.

S Kinmond1, R Carter, C H Skeoch

  • 1Intensive Therapy Unit, Royal Hospital for Sick Children, Glasgow.

Archives of Disease in Childhood
|May 1, 1990
PubMed
Summary

A pediatric case of Budd-Chiari syndrome and hepatic encephalopathy due to Wilms' tumor extension was successfully treated. Surgical tumor removal with cardiopulmonary bypass led to full recovery of liver function and neurological status.

Related Experiment Videos

Area of Science:

  • Pediatric oncology
  • Hepatology
  • Cardiovascular surgery

Background:

  • Budd-Chiari syndrome and hepatic encephalopathy can be life-threatening complications in children.
  • Intravascular extension of Wilms' tumor is a rare but critical presentation.

Observation:

  • A 3-year-old girl presented with acute Budd-Chiari syndrome and hepatic encephalopathy.
  • Echocardiography revealed intravascular extension of a Wilms' tumor as the cause.
  • The patient required intensive medical management followed by surgical intervention.

Findings:

  • Surgical resection of the Wilms' tumor was successfully performed using cardiopulmonary bypass with hypothermic circulatory arrest.
  • Post-operative resolution of hepatic failure was observed.
  • Complete neurological recovery was achieved following treatment.

Implications:

  • This case demonstrates the feasibility and effectiveness of aggressive surgical management for advanced Wilms' tumor with complex hepatic involvement.
  • Successful outcomes are possible even in critical pediatric cases with prompt diagnosis and multidisciplinary care.
  • Highlights the importance of echocardiography in identifying rare intravascular tumor extensions and guiding treatment strategies.