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K Blouhos, K A Boulas, A Paraskeva, I Kariotis, N Barettas, A Hatzigeorgiadis
INTRODUCTION: Secondary pancreatic tumors are uncommon and account for 2-5% of pancreatic cancer. Tumors characterized most commonly with pancreatic involvement are lymphoma, renal cell and lung carcinomas. PRESENTATION OF CASE: A 76-year-old female patient with obstructive jaundice as the primary symptom and inguinal lymphadenopathy is presented. Imaging revealed a bulky solitary solid pancreatic head mass along with paraaortic and mesenteric lymphadenopathy. The absence of a previous history of malignancy and the presence of a dominant pancreatic mass along with distal lymphadenopathy confined differential diagnosis to advanced secondary pancreatic lymphoma, which is the most common secondary pancreatic tumor, and locally advanced/metastatic pancreatic adenocarcinoma...
March 7, 2018: International Journal of Surgery Case Reports
Kristin Bjørnland, Maren Hinna, Gunnar Aksnes, Kjetil Juul Stensrud, Kjetil Ertresvåg, Anniken Bjørnstad-Østensen, Truls Sanengen, Pål-Dag Line, Ingegerd Aagenæs, Lars Aabakken, Ragnhild Emblem, Runar Almaas
OBJECTIVES: The importance of case load for treatment of extrahepatic biliary atresia (BA) is debated. The aim of this study was to register results of BA treatment in a small volume centre. METHODS: Retrospective chart review study of patients with BA treated from 2000 to 2017. The institutional review board approved the study. RESULTS: Forty-five babies were identified of which 42 (93%) are alive. Forty-one patients had a Kasai portoenterostomy (PE), two had a hepaticojejunostomy and two had a primary liver transplantation...
March 16, 2018: Scandinavian Journal of Gastroenterology
B M Kamath, A Baker, R Houwen, L Todorova, N Kerkar
BACKGROUND: Alagille syndrome (ALGS) is an inherited multisystem disorder typically manifesting as cholestasis, and potentially leading to end-stage liver disease and death. AIM: To perform the first systematic review of the epidemiology, natural history and burden of ALGS with a focus on the liver component. METHODS: Electronic databases and proceedings from key congresses were searched in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 guidelines...
March 14, 2018: Journal of Pediatric Gastroenterology and Nutrition
Asmaa Y Elsary, Alkassem A Elgameel, Wael S Mohammed, Osman M Zaki, Shaimaa A Taha
To assess the prevalence of hypocalcemia in outpatient clinic neonates and its relation to vitamin D and calcium supplementation.  Methods: This cross-sectional analytical study was conducted at the University Teaching Hospital from May to October 2016. Data were collected from 100 neonates by interviewing mothers using a structured questionnaire; which included socio-demographic information, maternal and neonatal history; in addition to investigations of serum calcium total and ionized and serum vitamin D level...
March 2018: Saudi Medical Journal
Carlos Fritzsche, M Loebermann, E C Reisinger
BACKGROUND: Vaccination against hepatitis A virus infection is recommended for men who have sex with men and other risk groups. The protection offered by the combined hepatitis A and B vaccine is comparable to that offered by the monovalent hepatitis A vaccine. CASE: A 38-year-old HIV-positive patient presented with right upper abdominal pain, fever and jaundice. Serological work-up and detection of hepatitis A RNA in stool sample revealed an acute hepatitis A infection despite a previous complete vaccination with the combined hepatitis A and B vaccine...
March 14, 2018: Infection
Benjamin R Poh, Paul A Cashin, Daniel G Croagh
INTRODUCTION: Traditional teaching dictates that it may not be prudent to take the jaundiced patient to theatre for emergency laparoscopic cholecystectomy as they may experience worse outcomes following surgery. METHODS: A prospective cohort of 104 patients undergoing emergency laparoscopic cholecystectomy was stratified into two groups using a serum total bilirubin of above 50 μmol/L (2.9 mg/dL) to define the jaundiced group. Primary outcomes were morbidity and mortality rate...
March 14, 2018: World Journal of Surgery
Agazi Gebreselassie, Majidah Bukhari, Ahmad Awan, Mouen Khashab
Portal vein thrombosis with cavernous transformation is a rare cause of biliary obstruction. Portal biliopathy is a term that refers to abnormalities in the intrahepatic and extrahepatic biliary tract, gall bladder, and cystic duct secondary to portal hypertension. Patients may be asymptomatic, but they can also present with abdominal pain, jaundice, and fever. We present the case of a 61-year-old Caucasian female who presented with generalized weakness, dark urine, and yellow skin for three days' duration...
January 9, 2018: Curēus
Chen Qu, Dandan Zheng, Sai Li, Yingjun Liu, Anna Lidofsky, Jacinta A Holmes, Jianning Chen, Lu He, Lan Wei, Yadi Liao, Hui Yuan, Qimeng Jin, Zelong Lin, Qiaoting Hu, Yuchuan Jiang, Mengxian Tu, Xijun Chen, Weiming Li, Wenyu Lin, Bryan C Fuchs, Raymond T Chung, Jian Hong
Spleen tyrosine kinase (SYK) plays a critical role in immune cell signaling pathways and has been reported as a novel biomarker for human hepatocellular carcinoma (HCC). We sought to investigate the mechanism by which SYK promotes liver fibrosis and to evaluate SYK as a therapeutic target for liver fibrosis. We evaluated the cellular localization of SYK and the association between SYK expression and liver fibrogenesis in normal, HBV-infected, HCV-infected and non-alcoholic steatohepatitis (NASH) liver tissue (n=36, 127, 22 and 30, respectively)...
March 14, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Adrián Róbert Gál, Károly Kalmár-Nagy, András Fincsur, Örs Péter Horváth, András Vereczkei
The authors present a case of a 67-year-old male patient, who previously had been diagnosed with a malignant liver tumor localized in segment II. He underwent bisegmentectomy (II and III) and partial IV segmentectomy. After the primary surgery jaundice developed, the level of bilirubin increased and after several imaging modalities reoperation was indicated. During the surgery a rare bile duct anatomy variant was found. The right hepatic duct joined the left duct in the parenchyma of the left lobe, and was ligated at the resection...
March 2018: Magyar Sebészet
Lucy Meunier, Jose Ursic-Bedoya, Georges-Philippe Pageaux, Dominique Larrey
BACKGROUND: Although very rare, pantoprazole can result in acute hepatitis. It has yet to be reported, however, that it can also cause chronic autoimmune hepatitis. AIM, METHOD, AND RESULTS: We report the case of a patient in whom pantoprazole administration for two months was followed by acute liver injury with severe jaundice and features of autoimmunity. A liver biopsy revealed acute hepatocellular lesions associated with cholestasis, acute cholangitis, and polymorphous inflammatory infiltration suggestive of drug-induced liver injury...
March 12, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
H Abdella, M K Shaker, Iman Fawzy Montasser, M Sobhi, H Aly, A Sayed, S Saleh, A El Dorry
BACKGROUND/AIM: Portal vein tumor thrombosis (PVTT) is a common complication in hepatocellular carcinoma (HCC) and it was considered a relative contraindication for transarterial chemoembolization (TACE) by many centers. This study aimed to assess the outcomes after TACE in patients with branch PVT regarding Child classification, radiological response, and 1-year survival. METHODS: Thirty HCC patients (24 male, 6 females) Child A cirrhotics with branch PVT underwent TACE...
March 13, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Rohit A Gupta, Meha N Motiwala, Ujawala N Mahajan, Sapna S Sabare
ETHNOPHARMACOLOGICAL RELEVANCE: The plant Sesbania grandiflora (Linn) belonging to the family Fabaceae is commonly known as sesbania, agathi, and katurai. The plant is accredited for alleviating a spectrum of ailments including inflammation, colitis, diarrhea, dysentery, leprosy, gout, rheumatism, jaundice, bronchitis, convulsion and anxiety. It is also used as antitumour, anthelmintic, and laxatives in Ayurveda and Siddha system of Indian traditional medicine. AIM: To reveal protective effect of Sesbania grandiflora in acetic acid induced ulcerative colitis in mice...
March 9, 2018: Journal of Ethnopharmacology
Frank Ursin, Florian Steger
INTRODUCTION:  Gallstones are rarely mentioned in the medical texts of antiquity. The physician, Alexander of Tralles mentions-for the first time-stones in the gallbladder as a possible cause for obstructive jaundice. This designation is found in his textbook on medicine under the heading "obstruction of the liver". Based on that observation, we describe the ancient history of hepatic obstruction and investigate the connection with the rare reference of gallstones in the medical texts of antiquity...
March 2018: Zeitschrift Für Gastroenterologie
Saishree Pradhan, Sriram Krishnamurthy, Barath Jagadisan, Nachiappa G Rajesh, Subashini Kaliaperumal, Suryaprakash Ramasamy, Nandeeswari Subramanian
A 12-year-old girl born to third-degree consanguineous parents presented with recurrent episodes of haematuria for 8 months in association with peri-orbital and lower limb oedema for 20 days. There was no jaundice, hepatomegaly or neurological abnormality at presentation. An older brother had died following jaundice at 10 years of age. Urinalysis showed multiple dysmorphic erythrocytes without proteinuria and there was leucopenia, thrombocytopenia and hypo-albuminaemia (23 g/L). C3 component of complementaemia was low and anti-nuclear antibodies and anti-double-stranded DNA antibodies were strongly positive by immunofluorescence...
March 12, 2018: Paediatrics and International Child Health
Daryl Ramai, Emmanuel Ofori, Sofia Nigar, Madhavi Reddy
Primary hepatic peripheral T-cell lymphoma (H-PTCL) is one of the rarest forms of non-Hodgkin lymphoma. We report a patient who presented with worsening jaundice, abdominal pain, and vomiting. Laboratory values were significant for elevated total bilirubin, alkaline phosphatase, and liver aminotransferases. Following a liver biopsy, histopathology revealed several large dense clusters of atypical T-lymphocytes which were CD2+, CD3+, CD5+, CD7-, CD4+, CD8-, CD56-, CD57-, CD30+ by immunohistochemistry. The proliferation index was approximately 70% by labeling for ki67/mib1...
February 27, 2018: World Journal of Hepatology
Yuji Eso, Norimitsu Uza, Kotaro Shirakawa, Kenji Sawada, Kentaro Katsuragi, Minoru Matsuura, Hiroshi Seno
We herein report a patient with a history of rheumatoid arthritis treated with methotrexate, which caused methotrexate-associated lymphoproliferative disorder and obstructive jaundice due to an enlarged lymph node. The obstructive jaundice was treated with endoscopic biliary stenting. A histopathological examination revealed features of Hodgkin's lymphoma, and chemotherapy with brentuximab vedotin was administered. Cholangiography and duodenoscopy after four rounds of chemotherapy revealed a choledochoduodenal fistula that developed in response to chemotherapy...
March 9, 2018: Internal Medicine
Shi-Jun Liu, Zhi-Shu Tang, Zhi-Xin Liao, Chun-Li Cui, Hong-Bo Liu, Yan-Ni Liang, Yu Zhang, Hong-Bo Xu, Dong-Bo Zhang, Ya-Ting Zheng, Huan-Xian Shi, Shi-Ying Li
ETHNOPHARMACOLOGICAL RELEVANCE: Ligularia przewalskii (Maxim.) Diels (LP) (called zhangyetuowu in Chinese), is generally found in moist forest areas in the western regions of China. The root, leaves and flower of LP are utilized as a common traditional medicine in China. It has been utilized conventionally in herbal remedies for the remedy of haemoptysis, asthma, pulmonary phthisis, jaundice hepatitis, food poisoning, bronchitis, cough, fever, wound healing, measles, carbuncle, swelling and phlegm diseases...
March 8, 2018: Journal of Ethnopharmacology
Peter J Lee, Amareshwar Podugu, Dong Wu, Arier C Lee, Tyler Stevens, John A Windsor
BACKGROUND: Controversy remains about the best pre-operative management of jaundice in patients with resectable pancreatic head cancer (RPC) undergoing planned pancreaticoduodenectomy (PD). OBJECTIVE: The aim of this study was to compare rates of post-operative complications in patients undergoing four pre-operative approaches (POA): preoperative biliary drainage with plastic stent (PBD-PS), metal stent (PBD-MS), and percutaneous transhepatic drain (PBD-PT), or no pre-operative biliary drainage (NPBD)...
March 8, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Neta Solomon, Ariel Many, Rotem Orbach, Dror Mandel, Shiri Shinar
BACKGROUND: Hyponatremia during labor and delivery may result in severe maternal and neonatal sequelae. Our aim was to describe the direct effect of hyponatremia in labor on pregnancy outcome. METHODS: A case series of parturients diagnosed with hyponatremia during labor and their neonates. Clinical presentation, laboratory workup, and maternal and neonatal outcomes are presented. RESULTS: Four parturients and their corresponding six neonates were diagnosed with hyponatremia...
March 12, 2018: Journal of Maternal-fetal & Neonatal Medicine
David Noiva Perdigoto, Pedro Amaro, Manuela Ferreira, Luis Tomé
A patient is admitted with complaints of recent onset nausea, discomfort, jaundice and blood tests that reveal severe hepatitis. At the time, she had been taking medication with Hypericum perforatum (St John's wort) for 6 months, and 6 weeks before this event, she took flupirtine maleate. A few days after being admitted, she developed encephalopathy progressing to acute liver failure (ALF) requiring unsuccessful liver transplantation. The patient was ultimately diagnosed with drug-induced liver injury (DILI)...
March 9, 2018: BMJ Case Reports
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