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Liver anatomy

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https://www.readbyqxmd.com/read/29769055/one-visceral-artery-may-be-enough-successful-pancreatectomy-in-a-patient-with-total-occlusion-of-the-celiac-and-superior-mesenteric-arteries
#1
Evangelos Tagkalos, Florian Jungmann, Hauke Lang, Stefan Heinrich
BACKGROUND: The anatomic variations of the visceral arteries are not uncommon. The liver arterial blood supply shows 50% variability between humans, with the most common anatomy being one hepatic artery arising from the celiac trunk and one pancreatico-duodenal arcade between the celiac trunk and the superior mesenteric artery. Occlusion of one artery are mostly asymptomatic but may become clinically relevant when surgery of the liver, bile duct or the pancreas is required. If these pathologies are not reversible, an oncologic pancreatic head resection cannot be performed...
May 16, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29761937/-mirror-mirror-on-the-wall-%C3%A2-pediatric-liver-transplantation-in-the-case-of-situs-inversus-totalis-with-a-disrupted-inferior-vena-cava
#2
Colston A Edgerton, Megan Gross, Nagraj Kasi, Winston Hewitt, Sara Edmondson, Vinayak S Rohan, Satish N Nadig
We present the unique case of a 15-month-old male born with biliary atresia and situs inversus totalis and disrupted inferior vena cava who underwent a successful liver transplantation. The patient had previously undergone a failed Kasai procedure and presented with persistent hyperbilirubinemia. The patient was transplanted with a left lateral segment donor having standard arterial anatomy. Technical considerations included identifying completely replaced arterial anatomy in the recipient from the superior mesenteric artery and creating a branch patch between the gastroduodenal artery and HA, anastomosing the donor left hepatic vein to confluences of the donor left, middle, and right hepatic veins, using a "lazy-S" configuration of portal vein anastomosis, and suspending the allograft to the abdominal wall...
May 15, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29750708/endometrioid-adenocarcinoma-with-solitary-metastasis-to-the-appendix-mimicking-primary-appendiceal-adenocarcinoma-a-case-report-and-literature-review
#3
Qiujie Ma, Jianshe Wu
Metastatic tumors of the appendix are rare. Endometrial cancer tends to metastasize by directly invading neighboring structures; the lung, liver, bones, and brain are common sites of distant metastasis. Herein, we present a case of a solitary endometrial metastatic tumor in the appendiceal mucosa without serosal involvement that mimicked a primary adenocarcinoma of the appendix. The patient who had undergone a radical hysterectomy for an endometrioid adenocarcinoma 3 years earlier presented to the hospital with a history of persistent right-lower abdominal pain...
May 10, 2018: International Journal of Gynecological Pathology
https://www.readbyqxmd.com/read/29730740/congenital-portosystemic-shunts-diagnosis-and-treatment
#4
Stéphanie Franchi-Abella, Emmanuel Gonzales, Oanez Ackermann, Sophie Branchereau, Danièle Pariente, Florent Guérin
Congenital portosystemic shunts (CPSS) are rare vascular malformations that create an abnormal connection between portal and systemic veins resulting in complete or partial diversion of the portal flow away from the liver to the systemic venous system. Different anatomic types exist and several classifications have been proposed. They can be associated with other malformations especially cardiac and heterotaxia. The main complications include hepatic encephalopathy, liver tumors, portopulmonary hypertension, and pulmonary arteriovenous shunts...
May 5, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29727331/10th-anniversary-of-alpps-lessons-learned-and-quo-vadis
#5
Hauke Lang, Eduardo de Santibañes, Hans J Schlitt, Massimo Malagó, Thomas van Gulik, Marcel A Machado, Elio Jovine, Stefan Heinrich, Giuseppe Maria Ettorre, Albert Chan, Roberto Hernandez-Alejandro, Ricardo Robles Campos, Per Sandström, Michael Linecker, Pierre-Alain Clavien
OBJECTIVE: Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) has been tested in various indications and clinical scenarios, leading to steady improvements in safety. This report presents the current status of ALPPS. SUMMARY BACKGROUND DATA: ALPPS offers improved resectability, but drawbacks are regularly pointed out regarding safety and oncologic benefits. METHODS: During the 12th biennial congress of the European African-Hepato-Pancreato-Biliary Association (Mainz, Germany, May 23-26, 2017) an expert meeting "10th anniversary of ALPP" was held to discuss indications, management, mechanisms of regeneration, as well as pitfalls of this novel technique...
May 1, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29722074/analysis-of-caudate-lobe-biliary-anatomy-and-its-implications-in-living-donor-liver-transplantation-a-single-centre-prospective-study
#6
Kausar Makki, Vishal Chorasiya, Ajitabh Srivastava, Ashish Singhal, Arif Ali Khan, Vivek Vij
Biliary complications are a significant cause of morbidity after living donor liver transplant (LDLT). Bile leak may occur from bile duct (anastomotic site in recipient and repaired bile duct stump in donor), cystic duct stump, cut surface pedicles or from divided caudate ducts. The first three sites are amenable to post-operative endoscopic stenting as they are in continuation with biliary ductal system. However, leaks from divided isolated caudate ducts can be stubborn. To minimize caudate duct bile leaks, it is important to understand the anatomy of hilum with attention to the caudate lobe biliary drainage...
May 2, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29706445/reoperative-complications-following-pediatric-liver-transplantation
#7
Dor Yoeli, Ruth L Ackah, Rohini R Sigireddi, Michael L Kueht, N Thao N Galvan, Ronald T Cotton, Abbas Rana, Christine A O'Mahony, John A Goss
BACKGROUND: The aim of this study is to describe the incidence and impact of reoperation following pediatric liver transplantation, as well as the indications and risk factors for these complications. METHODS: All primary pediatric liver transplants performed at our institution between January 2012 and September 2016 were reviewed. A reoperative complication was defined as a complication requiring return to the operating room within 30 days or the same hospital admission as the transplant operation, excluding retransplantation...
April 7, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29701873/children-with-intestinal-failure-undergoing-intestinal-rehabilitation-are-at-risk-for-essential-fatty-acid-deficiency
#8
Riikka Gunnar, Mirka Lumia, Mikko Pakarinen, Laura Merras-Salmio
BACKGROUND: Essential fatty acid (EFA) status may be compromised during the intestinal failure (IF) rehabilitation. Parenteral lipid restriction is used to treat intestinal failure associated liver disease (IFALD), while the enteral fatty acid (FA) absorption remains limited. We analyzed the FA status among pediatric IF and intestinal insufficiency patients. METHODS: We evaluated 49 patients aged 0-18 years attending our nationwide IF referral center. Their serum FA fractions were determined and examined against previous nutrition, parenteral lipid emulsion, and intestinal anatomy data...
April 27, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29701871/pediatric-intestinal-failure-the-key-outcomes-for-the-first-100-patients-treated-in-a-national-tertiary-referral-center-during-1984-2017
#9
Laura Merras-Salmio, Annika Mutanen, Elisa Ylinen, Risto Rintala, Antti Koivusalo, Mikko P Pakarinen
BACKGROUND: Pediatric-onset intestinal failure (IF) remains a severe illness with life-threatening consequences. In this study, we analyzed a single center's outcomes of IF over 3 decades. METHODS: All children with IF who required parenteral nutrition (PN) >2 months or small-intestinal resection ≥50% managed since 1984 were included for retrospective outcome analyses. RESULTS: In total, 100 patients with median PN duration of 1.2 (interquartile range, 0...
April 27, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29696320/liver-vascular-anatomy-a-refresher
#10
Rishi Philip Mathew, Sudhakar Kundapur Venkatesh
To prevent and decrease procedural complications, it is important to identify variants of hepatic vascular anatomy before interventional radiologic procedures, surgery, and liver transplantation. Knowledge of the vascular variants helps in selecting patients and in exploring alternative management options. Non-invasive detailed demonstration of the hepatic vascular anatomy is possible with advanced multi-detector computed tomography (CT) and magnetic resonance (MR) imaging. The objective of this review is to provide a brief overview of clinically relevant hepatic vascular anatomy and important variants...
April 25, 2018: Abdominal Radiology
https://www.readbyqxmd.com/read/29685522/rapid-switching-kvp-dual-energy-ct-value-of-reconstructed-dual-energy-ct-images-and-organ-dose-assessment-in-multiphasic-liver-ct-exams
#11
Usman Mahmood, Natally Horvat, Joao Vicente Horvat, Davinia Ryan, Yiming Gao, Gabriella Carollo, Rommel DeOcampo, Richard K Do, Seth Katz, Scott Gerst, C Ross Schmidtlein, Lawrence Dauer, Yusuf Erdi, Lorenzo Mannelli
PURPOSE: Clinical applications of dual energy computed tomography (DECT) have been widely reported; however, the importance of the different image reconstructions and radiation organ dose remains a relevant area of investigation, particularly considering the different commercially available DECT equipment. Therefore, the purpose of this study was to assess the image reliability and compare the information content between several image reconstructions in a rapid-switching DECT (rsDECT), and assess radiation organ dose between rsDECT and conventional single-energy computed tomography (SECT) exams...
May 2018: European Journal of Radiology
https://www.readbyqxmd.com/read/29675774/radioembolization-for-hepatocellular-carcinoma-arising-in-the-setting-of-a-congenital-extrahepatic-portosystemic-shunt-abernethy-malformation
#12
Thomas Kroencke, Marcus Murnauer, Frank Alexander Jordan, Vera Blodow, Hannes Ruhnke, Tina Schaller, Bruno Märkl
In a 50-year-old male with an incidentally discovered hepatocellular carcinoma, a congenital extrahepatic portosystemic shunt with the absence of the portal vein (Abernethy syndrome) was diagnosed by imaging. This study aims to discuss the variant anatomy relevant to this splanchnic vascular malformation, review its association with the development of liver neoplasms, and report the safety and efficacy of TARE followed by resection for a HCC arising in this rare condition.
April 19, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29671198/cancer-community-education-in-somali-refugees-in-nebraska
#13
Shinobu Watanabe-Galloway, Nada Alnaji, Brandon Grimm, Melissa Leypoldt
Nebraska has one of the highest numbers of refugees per capita in the U.S. A high number of Somalis have resettled in Nebraska due to job opportunities and the low cost of living. In this paper, we report the process and the results of a cervical and breast cancer education program for Somali women conducted through a collaboration among public health, academia, and community entities. The curriculum was built to be suitable for the literacy level and cultural values of this community. Topics include female reproductive anatomy; breast and cervical cancer knowledge and screening; hepatitis C and liver cancer; and preparing for a health screening visit...
April 18, 2018: Journal of Community Health
https://www.readbyqxmd.com/read/29651794/celiac-trunk-and-common-hepatic-artery-variations-in-children-an-analysis-with-ct-angiography
#14
Emine Caliskan, Turker Acar, Mehmet Ozturk, Zuhal Bayramoglu, Ravza Yilmaz, Filiz Elbuken, Ibrahim Adaletli
BACKGROUND: Understanding the celiac trunk and hepatic artery anatomy is important not only in preventing iatrogenic injuries but also in planning surgical procedures in children. Therefore, the aim of this study is to analyze the prevalence of celiac trunk (CeT) and common hepatic artery (CHA) variations in the pediatric population. MATERIALS AND METHODS: One hundred and seventy-four children (174) who underwent abdominal multidetector computed tomography (MDCT) angiography, either because of trauma or liver transplantation, were analyzed retrospectively...
April 13, 2018: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/29626027/lesson-of-the-month-1-massive-spontaneous-haematomas-in-an-elderly-man
#15
Francesco Fiorini, Louise Braddick, Hasnain Hashim, Robert M Ayto, Alana Jacobs, Yetunde Baoku, Shahir S Hamdulay
A 73-year-old man presented with bilateral leg pain and swelling, and no history of trauma or bleeding disorders. Clinical examination, biochemistry and magnetic resonance imaging of the thighs were suggestive of muscle haematomas. These progressed significantly during the admission, requiring blood transfusion. Normal vascular anatomy on computed tomography, renal and liver function, and absence of infection made a bleeding diathesis more likely. This may be caused by coagulation defects, platelet disorders and vascular fragility...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29613889/extracorporeal-membrane-oxygenation-in-a-pediatric-patient-with-hepatopulmonary-syndrome-and-interrupted-inferior-vena-cava-after-living-related-liver-donation
#16
Michael R Phillips, Marc Priest, Christopher Beaty, Robert Parker, Marisa Meyer, Stephen Dunn, Curtis D Froehlich, Daniel R Dirnberger, Abigail E Martin, Mark T Ogino
Extracorporeal membrane oxygenation (ECMO) is used for cardiopulmonary dysfunction. Hepatopulmonary syndrome (HPS) occurs in the setting of liver failure and may cause hypoxemia. Previous reports have described the use of ECMO for HPS after liver transplant. Our patient is a 19-month-old female with biliary atresia, an interrupted inferior vena cava, and HPS on 8 liters per minute of high-flow oxygen. Following liver transplantation, her postoperative course was complicated by severe hypoxemia requiring ECMO...
March 30, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29609888/impact-of-hemodynamics-and-fluid-energetics-on-liver-fibrosis-after-fontan-operation
#17
Phillip M Trusty, Zhenglun Wei, Jack Rychik, Pierre A Russo, Lea F Surrey, David J Goldberg, Mark A Fogel, Ajit P Yoganathan
OBJECTIVE: The staged Fontan procedure has shown promising short-term outcomes in patients with single ventricles. However, Fontan-associated liver disease is a marked problem as patients age. The purpose of this study is to investigate the relationship between hemodynamics and liver fibrosis in patients undergoing the Fontan. METHODS: A total of 33 patients undergoing the Fontan with liver fibrosis were included in this study. Cardiac magnetic resonance and phase-contrast cardiac magnetic resonance data, as well as catheterization measurements and liver biopsies, were obtained for each patient...
March 7, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29600345/tips-and-tricks-for-a-laparoscopic-approach-to-paracaval-liver-segments
#18
G Fiorentini, F Ratti, F Cipriani, M Catena, M Paganelli, L Aldrighetti
BACKGROUND: A dramatic spread of laparoscopic liver surgery has been experienced over the last years. The approach to paracaval liver segments 1 and 9 is still poorly described in literature, mainly due to its technical demands. OBJECTIVE: The aim of this article was to introduce a safe and effective approach to paracaval liver segments through laparoscopy. METHODS: A minimally invasive approach to resection of Segments 1 and 9 is presented, and an operative set-up is depicted...
March 29, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29580343/incidence-and-impact-of-variant-celiacomesenteric-vascularization-and-vascular-stenosis-on-pancreatic-surgery-outcomes-personal-experience
#19
Alejandro M Sánchez, Antonio P Tortorelli, Paola Caprino, Fausto Rosa, Roberta Menghi, Giuseppe Quero, Giovanni B Doglietto, Sergio Alfieri
Ischemic complications after pancreatic surgery can raise postoperative mortality from 4 to 83 per cent. Variants in vascular anatomy play a major role in determining such complications, but they have been only occasionally reported in the literature. We retrospectively analyzed 100 records of patients consecutively treated between January 2011 and December 2013 for resectable malignant diseases who underwent pancreaticoduodenectomy (PD) or total pancreatectomy to state the statistical impact of anatomical vascular variations in surgical outcomes (mean surgical timing, mean blood loss during surgery, and postoperative major complications onset) and to state whether preoperatively undetected vascular anomalies (VA) can raise the risk of postoperative ischemic complications...
February 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29564544/incidence-and-management-of-arterial-injuries-during-pancreatectomy
#20
Dyre Kleive, Mushegh A Sahakyan, Ammar Khan, Bjarte Fosby, Pål-Dag Line, Knut Jørgen Labori
PURPOSE: The incidence of intraoperative arterial injury during pancreatectomy is not well described. This study aims to evaluate the incidence, management, and outcome of arterial injuries during pancreatectomy. METHODS: This is a retrospective study of 1535 consecutive patients undergoing pancreatectomy between 2006 and 2016 at Oslo University Hospital. The type of arterial injury and potential contributing factors were analyzed. Short-term outcomes were compared between patients with arterial injury and patients undergoing a planned arterial resection due to tumor involvement...
March 21, 2018: Langenbeck's Archives of Surgery
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