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https://www.readbyqxmd.com/read/29118875/a-fatal-case-of-intra-abdominal-hemorrhage-following-diagnostic-blind-percutaneous-liver-biopsy-in-a-patient-with-peliosis-hepatis
#1
Saptarshi Biswas, Shekhar Gogna, Prem Patel
Peliosis hepatis (PH) is a rare vascular condition of the liver characterized by the presence of cystic blood filled cavities distributed randomly throughout the liver parenchyma. We describe a case of a 42-year-old previously healthy male patient, airlifted to us in a state of hemorrhagic shock after undergoing percutaneous diagnostic liver biopsy for lesions seen on CT scan. Repeat CT scan with IV contrast on presentation in our hospital showed intraperitoneal bleeding. Hepatic angiography failed to identify any specific bleeding source...
October 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/29098108/vaginal-cuff-dehiscence-presenting-with-free-air-60-days-after-robotic-assisted-hysterectomy
#2
D Munger, M Iannamorelli, C Galvez, C Service
Introduction: The vast majority of patients presenting with pneumoperitoneum have visceral organ perforation and require urgent diagnostic laparoscopy. Nonsurgical causes are relatively rare and may be attributed to multiple etiologies. Case Presentation: Here we describe the case of a 38-year-old Caucasian female who presented to the emergency department with three days of cramping, epigastric abdominal pain. Her physical exam was notable for tenderness to palpation in the epigastric area and abdominal and chest X-rays showed free air under the diaphragm...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/29089711/ligation-of-the-left-hepatic-duct-and-proper-hepatic-artery-following-a-traffic-accident-injury
#3
Jiang Ou, Liu Yu, Cheng Nan-Sheng
A 32-year-old man was admitted to our hospital due to a traffic accident. Intraoperative observations revealed hemoperitoneum, splenic transection, pancreatic tail contusion, comminuted injury in the porta hepatis, rupture in the left hepatic duct, an irregular crevasse in the ductus hepaticus communis, the caudate lobe was transversely broken on the left, and under the gap, there was a fracture in retrohepatic inferior vena cava with huge retroperitoneal hematoma. We carried out a ligation of the left hepatic duct and the proper hepatic artery...
October 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29082453/rapidly-growing-hepatocellular-carcinoma-after-direct-acting-antiviral-treatment-of-chronic-hepatitis-c
#4
Toshihiro Kawaguchi, Tatsuya Ide, Hironori Koga, Reiichiro Kondo, Ichiro Miyajima, Teruko Arinaga-Hino, Reiichiro Kuwahara, Keisuke Amano, Takashi Niizeki, Masahito Nakano, Ryoko Kuromatsu, Takuji Torimura
We report on a 62-year-old man with chronic hepatitis C who developed rapidly growing hepatocellular carcinoma (HCC) after achieving sustained virological response at post-treatment week 24 (SVR 24) by direct-acting antiviral (DAA) treatment. In 2008, he failed interferon therapy at 56 years of age. He received daclatasvir plus asunaprevir for 24 weeks after confirmation of no liver tumor by abdominal ultrasonography. He had no advanced liver fibrosis. Three months after initiation of DAA treatment, a liver tumor measuring 6 mm in diameter was detected by ultrasonography and confirmed with magnetic resonance imaging...
October 29, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29078606/depicting-surgical-anatomy-of-the-porta-hepatis-in-living-donor-liver-transplantation
#5
Paul Kelly, Albert Fung, Joy Qu, Paul Greig, Gordon Tait, Jodie Jenkinson, Ian McGilvray, Anne Agur
Visualizing the complex anatomy of vascular and biliary structures of the liver on a case-by-case basis has been challenging. A living donor liver transplant (LDLT) right hepatectomy case, with focus on the porta hepatis, was used to demonstrate an innovative method to visualize anatomy with the purpose of refining preoperative planning and teaching of complex surgical procedures. The production of an animation-enhanced video consisted of many stages including the integration of pre-surgical planning; case-specific footage and 3D models of the liver and associated vasculature, reconstructed from contrast-enhanced CTs...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29062453/schwannoma-in-the-porta-hepatis-laparoscopic-excision-under-laparoscopic-ultrasound-guidance
#6
Maciej Sebastian, Maciej Sroczyński, Piotr Donizy, Jerzy Rudnicki
Schwannomas are usually benign tumors attached to peripheral nerves and are rarely found in the gastrointestinal tract. Schwannomas in the porta hepatis are extremely rare, with only 15 cases described in the literature to date. A 22-year-old female patient presented with colicky upper abdominal pain lasting 3 months. Magnetic resonance imaging of the abdominal cavity revealed a tumor in the porta hepatis. The patient was qualified for laparoscopy. The tumor was totally excised laparoscopically under guidance of laparoscopic ultrasound without intra- or postoperative complications...
September 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29056018/-the-role-of-the-balance-between-th17-and-treg-in-liver-disease
#7
Z Jin, J You, H T Wang
Naïve CD4+T cell differentiates into either Th17 or Treg in the microenvironment of various cytokines, among that, Th17 is induced by TGF-β and IL-6, while differentiates into Treg when there is only TGF-β. As the mainly transcription factors of Th17 and Treg respectively, RORγt and Foxp3 have important role in maintaining balance of Th17/Treg. Th17 and Treg are function antagonistically, so the balance of Th17/Treg means a lot for human body. Liver-a metabolic organof the body, it is susceptible to factors in vivo and in vitro...
August 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29022092/unique-manifestations-of-biliary-atresia-provide-new-immunological-insight-into-its-etiopathogenesis
#8
REVIEW
Toshihiro Muraji, Haruo Ohtani, Satoshi Ieiri
Biliary atresia (BA) is a unique cholestatic disease of newborns with a background of exaggerated immune response in the liver of unknown mechanism. Three hypotheses have been proposed; autoimmune type of cholangiopathy triggered by virus infection, graft-versus-host disease type of immune-mediated disease associated with maternal microchimerism and ductal plate malformation theory. Researchers on virus infection theory have experimentally explored immune process causing cholangiopathy on murine models of this disease, while in maternal microchimerism hypothesis were detected maternal cells in the BA patients' liver, of which roles are yet to be determined...
December 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28990003/liver-lesions-detected-in-a-hepatitis-b-core-total-antibody-positive-patient-masquerading-as-hepatocellular-carcinoma-a-rare-case-of-peliosis-hepatis-and-a-review-of-the-literature
#9
Chun Han Nigel Tan, Gwyneth Shook Ting Soon, Wei Chieh Alfred Kow
Peliosis Hepatis (PH) is a rare vascular disorder of the liver, characterized by the presence of cystic blood-filled cavities distributed throughout the hepatic parenchyma. The pathogenesis of PH remains controversial. The preoperative diagnosis of PH is difficult, due to the non-specific imaging characteristics of PH and almost all cases are diagnosed on histology post resection. This study presents a case of PH masquerading as hepatocellular carcinoma (HCC). The patient is a 45-year old Chinese lady, who presented with transaminitis...
August 2017: Annals of Hepato-Biliary-Pancreatic Surgery
https://www.readbyqxmd.com/read/28980051/surgical-modifications-additions-and-alternatives-to-kasai-hepato-portoenterostomy-to-improve-the-outcome-in-biliary-atresia
#10
REVIEW
Shilpa Sharma, Devendra K Gupta
Kasai hepato-portoenterostomy (HPE) is the most widely used surgical technique to restore bile flow in biliary atresia (BA). We aimed to review literature on HPE substitutes and additions to Kasai especially in advanced BA (ABA). A PubMed search was done for surgical procedures apart from or along with Kasai HPE for BA. Additional procedures to prevent cholangitis were also reviewed. Procedures and outcome were analysed. Alternative procedures done by the authors have also been described briefly. Results have been compiled in this review article...
December 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28969242/unusual-branching-pattern-of-the-portal-vein-its-importance
#11
Sreedhara B Cheluvashetty, Vamsidhar Rachapalli
Portal vein anatomy and its branching pattern are of utmost importance for surgical planning of complex liver resections, living donor liver transplant and radiological procedures. The division of the vein at the porta hepatis, into the right and left branches is the most common branching pattern. Various branching variations have been described. We report a previously undescribed branching pattern of the right portal vein, where the segment VII vein arises directly from the left portal vein.
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28956136/current-management-of-long-term-survivors-of-biliary-atresia-over-40%C3%A2-years-of-experience-in-a-single-center-and-review-of-the-literature
#12
Hideyuki Sasaki, Hiromu Tanaka, Masaki Nio
INTRODUCTION: Owing to several therapeutic advancements, more patients with biliary atresia now survive into adulthood while retaining their native liver. However, the optimal strategy for long-term management of such patients remains unclear. METHODS: Aiming to establish the current management strategies, we reviewed previous reports of long-term outcome of BA who underwent surgery at our institution as well as the relevant literature, focusing particularly on the treatment of late complications...
December 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28906410/augmented-reality-navigation-in-open-surgery-for-hilar-cholangiocarcinoma-resection-with-hemihepatectomy-using-video-based-in-situ-three-dimensional-anatomical-modeling-a-case-report
#13
Rui Tang, Longfei Ma, Canhong Xiang, Xuedong Wang, Ang Li, Hongen Liao, Jiahong Dong
RATIONALE: Patients who undergo hilar cholangiocarcinoma (HCAC) resection with concomitant hepatectomy have a high risk of postoperative morbidity and mortality due to surgical trauma to the hepatic and biliary vasculature. PATIENT CONCERNS: A 58-year-old Chinese man with yellowing skin and sclera, abdominal distension, pruritus, and anorexia for approximately 3 weeks. DIAGNOSES: Magnetic resonance cholangiopancreatography and enhanced computed tomography (CT) scanning revealed a mass over the biliary tree at the porta hepatis, which diagnosed to be s a hilar cholangiocarcinoma...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28871567/a-case-of-biliary-atresia-with-pancreaticobiliary-maljunction
#14
Kosuke Endo, Akiko Yokoi, Yasuhiko Mishima, Akihiko Tamaki, Keiichi Morita, Yuichi Okata, Chieko Hisamatsu, Hiroaki Fukuzawa, Makiko Yoshida, Yoshinobu Akasaka, Kosaku Maeda
BACKGROUND: The pathogenesis of biliary atresia (BA) is still unknown. There are several reports on the etiology of BA, including pancreaticobiliary maljunction (PBM). We experienced a case of Kasai type IIIa BA with PBM, in which we found elevation of pancreatic enzymes in the gallbladder. We evaluated whether PBM is related to the pathogenesis of BA based on our findings. CASE PRESENTATION: The patient was born at 40 weeks of gestation. His body weight at birth was 2850 g...
September 5, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28830230/radiological-predictors-of-complete-cytoreduction-in-59-patients-with-peritoneal-mesothelioma-treated-with-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-at-a-uk-referral-centre
#15
Anuradha Chandramohan, Andrew Thrower, Nehal Shah, Faheez Mohamed
OBJECTIVE: To assess the imaging features of peritoneal mesothelioma and identify key anatomical sites that aid patient selection for complete cytoreduction. METHODS: Pre-operative imaging of 59 (32 males, 27 females) patients who underwent cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) for histologically proven peritoneal mesothelioma [36 malignant peritoneal mesothelioma, 23 cystic mesothelioma were reviewed. Imaging findings were correlated with surgical outcome...
November 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28828110/hepatoduodenal-lymph-node-metastasis-mimicking-klatskin-tumor-in-a-patient-with-sigmoid-colon-mucinous-cancer
#16
Hovhannes Vardevanyan, Josef Holzinger, Rosemarie Forstner
We report a case of a 48-year-old female patient, who presented with abdominal pain, jaundice, and lack of appetite. Ultrasound showed intrahepatic biliary dilatation with retroperitoneal lymphadenopathy. Further magnetic resonance cholangiopancreatography detected Klatskin tumor. Computed tomography (CT) confirmed the Klatskin tumor with liver metastases and retroperitoneal lymphadenopathy. Biopsy from the hepatic lesion identified mucinous adenocarcinoma, likely originating from bile ducts. Endoscopic retrograde cholangiopancreatography was performed 3 times with stents placed in the left and right hepatic bile ducts...
September 2017: Radiology case reports
https://www.readbyqxmd.com/read/28721347/peliosis-hepatis-complicating-pregnancy-a-rare-entity
#17
Muhammad Osama Butt, Nasir Hassan Luck, Syed Mujahid Hassan, Zaigham Abbas, Muhammed Mubarak
Peliosis hepatis (PH) is a rare, benign condition of the liver characterized by the presence of blood-filled lacunar spaces in the parenchyma. It usually has a chronic presentation and is a rare cause of portal hypertension reported in adult patients. Its etiology is diverse and ranges from infectious agents to tumors to toxic substances and anabolic steroids; however, the cause remains unclear in 25-50% of patients. Similarly, the symptomatology and imaging findings are diverse. Biopsy is the definitive test to diagnose the condition...
June 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28679994/multicentric-castleman-s-disease-with-multiple-hepatic-mass-lesions-mimicking-malignant-liver-tumors
#18
Toshimitsu Ueki, Masaru Nasuno, Hiroko Kaiume, Yuki Hiroshima, Masahiko Sumi, Masahide Watanabe, Dai Inoue, Yasufumi Masaki, Yasuharu Sato, Masaru Kojima, Hikaru Kobayashi
Multicentric Castleman's disease (MCD) is a rare, non-malignant lymphoproliferative disorder. We report a case of MCD with multiple liver masses. A 26-year-old woman presented with asymptomatic anemia and hypoalbuminemia. Laboratory tests detected high CRP levels and findings indicative of polyclonal gammopathy. Abdominal CT revealed multiple hepatic large masses (≤10 cm) and partial calcification in the right lobe. Multiple enlarged lymph nodes were also identified in the cardiophrenic angle and porta hepatis...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28647717/a-large-choledochocystolithiasis-mimicking-mirizzi-syndrome
#19
Mustafa Belal Hafeez Chaudhry, Muhammad Azeemuddin, Muhammad Rizwan Khan, Om Parkash
An 18-year-old man presented with spontaneous severe epigastric pain, progressing and radiating to back since 3 days. It was associated with epigastric tenderness, bilious vomiting and jaundice. He had been intermittently experiencing these symptoms for the last 1 year. No known comorbid. Ultrasound showed a poorly visualised heterogeneous focus at porta hepatis; considering poor visualisation, this might represent an enlarged calcified lymph node or cystic duct calculus causing extrinsic compression or a large sludge ball within the common bile duct (CBD), leading to dilatation of common hepatic duct and intrahepatic biliary system...
June 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28643061/reoperation-for-recurrent-hepatolithiasis-laparotomy-versus-laparoscopy
#20
Qingfan Pu, Chuanrong Zhang, Zhenfeng Huang, Yu Zeng
BACKGROUND: Laparoscopy has been proposed for the management of recurrent hepatolithiasis, but no comparative study of its relative efficacy versus laparotomy has been performed, and the patient selection criteria for laparoscopy are not clear. This study aimed to investigate the therapeutic effect of laparoscopy versus laparotomy for repeated hepatolithiasis and to highlight how to select patients best suited for laparoscopy. METHODS: We performed a cohort study of 94 patients who underwent laparotomy or laparoscopy for recurrent hepatolithiasis between January 2010 and May 2014...
August 2017: Surgical Endoscopy
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