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liver resection shunt

Tae-Min Choi, Young-Jun Cheon, Tae-Young Jung, Kyung-Hwa Lee
A 63-year-old man complained of intermittent motor weakness of his arm. The magnetic resonance image (MRI) of his brain displayed a high signal lesion in right cingulate gyrus on T2 weighted image. One year later, he showed a stuporous mental status with repeated seizures, and the follow-up brain MRI showed heterogeneously enhanced mass associated with bleeding. He was treated with surgery and radiotherapy for secondary glioblastomas in right cingulate gyrus. One year more later, a mass recurred on the left frontal base, and gliosarcoma was diagnosed...
October 2016: Brain Tumor Research and Treatment
Susumu Takamatsu, Kota Sato, Shunsuke Kato, Hiroto Nagano, Shunro Ohtsukasa, Yasuyuki Kawachi
A 33-year-old man who presented with prolonged epigastric pain was referred to our hospital. He had experienced recurrent epistaxis and had a family history of hereditary hemorrhagic telangiectasia. Computed tomography and magnetic resonance imaging revealed splenomegaly and a 9 cm hypervascular mass in his spleen. Computed tomography also showed a pulmonary arteriovenous malformation and heterogeneous enhancement of the liver parenchyma, suggesting the presence of arteriosystemic shunts and telangiectases...
2016: Case Reports in Medicine
Filippo Banchini, Roberta Santoni, Antonio Banchini, Flavio Cesare Bodini, Patrizio Capelli
INTRODUCTION: Posterior right diaphragmatic hernia is rare in newborn patients but when present, is accompanied by high mortality. Pulmonary hypoplasia seems to be the main cause of death but the presence of liver involvement remains one of the reasons for poor prognosis even when intrauterine surgery is performed. CASE DESCRIPTION: In this article, we will present a rare case that was diagnosed by chance in a 65-year old adult presenting with an adenocarcinoma of the rectosigmoid junction and a right Bochdalek hernia with liver herniation and modification of the hepatic vein outflow with a natural right to left shunt...
2016: SpringerPlus
Catalina Correa, Juan P Luengas, Scott C Howard, Galo Veintemilla
A 2-year-old boy presented with pneumonia and an abdominal mass was noted incidentally. A right lobe hepatic mass classified as PRETEXT III and congenital absence of the portal vein with drainage of the superior mesenteric vein to the inferior vena cava (Abernethy malformation type I) were confirmed by computed tomography and angiography. After a clinical diagnosis of hepatoblastoma had been made, he was treated with 4 cycles of doxorubicin and cisplatin and hepatic arterial chemoembolization with doxorubicin, after which the tumor was classified as POSTEXT III...
March 2017: Journal of Pediatric Hematology/oncology
Matteo Ravaioli, Matteo Serenari, Matteo Cescon, Carlo Savini, Alessandro Cucchetti, Giorgio Ercolani, Massimo Del Gaudio, Alberto Casati, Antonio Daniele Pinna
BACKGROUND: Leiomyosarcoma of vascular origin is a rare tumor, occurring mainly in the inferior vena cava (IVC). When involving the hepatic vein confluence, it often causes Budd-Chiari syndrome, and IVC removal with a complex hepatectomy is required (Mingoli in J Am Coll Surg 211:145-146, 2010; Griffin in J Surg Oncol 34:53-60, 1987; Heaney in Ann Surg 163:237-241, 1966; Fortner in Ann Surg 180:644-652, 1974). METHODS: A 57-year-old male, without previous oncological history, presented with Budd-Chiari syndrome due to a leiomyosarcoma extending to the supra-diaphragmatic IVC and involving the right and middle hepatic veins...
July 18, 2016: Annals of Surgical Oncology
Michail Papamichail, Amir Ali, Alberto Quaglia, John Karani, Nigel Heaton
Intrahepatic portosystemic shunts (IPSS) are rare congenital anomalies arising from disordered portal vein embryogenesis. It has been described in both children and adults and may be asymptomatic or be associated with a variety of neurophysiological and pulmonary complications. When recognized, early intervention to occlude the shunt will reverse the associated complications. Literature review reports of surgical and radiological occlusion of the shunt, but due to its rarity, a standard therapeutic protocol has not been established...
June 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Salman A A Jabbar, Nigel B Jamieson, Andrew J Morris, Karin A Oien, Fraser Duthie, Colin J McKay, Christopher R Carter, Euan J Dickson
Abdominal surgery performed in patients with significant liver disease and portal hypertension is associated with high mortality rates, with even poorer outcomes associated with complex pancreaticobiliary operations. We report on a patient requiring portal decompression via transjugular intrahepatic portosystemic shunt (TIPS) prior to a pancreaticoduodenectomy. The 49-year-old patient presented with pain, jaundice and weight loss. At ERCP an edematous ampulla was biopsied, revealing high-grade dysplasia within a distal bile duct adenoma...
2016: Journal of Surgical Case Reports
Bertrand Le Roy, Johan Gagnière, Pascal Chabrot, Denis Pezet, Armand Abergel, Emmanuel Buc
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) is the standard procedure in the treatment of refractory ascites and variceal bleeding in the setting of portal hypertension. Secondary obstruction of the shunt is a classic but potentially lethal complication. METHODS: We present here the case of a cirrhotic patient that underwent a TIPS for refractory ascites, with early complete thrombosis without lethal complication. RESULTS: Obstruction of the TIPS led to thrombosis of both the right hepatic and the right portal veins with progressive total atrophy of the right liver and marked hypertrophy of the left liver...
September 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Ahmed Mukhtar, Hany Dabbous
Splanchnic circulation is the primary mechanism that regulates volumes of circulating blood and systemic blood pressure in patients with cirrhosis accompanied by portal hypertension. Recently, interest has been expressed in modulating splanchnic circulation in patients with liver cirrhosis, because this capability might produce beneficial effects in cirrhotic patients undergoing a liver transplant. Pharmacologic modulation of splanchnic circulation by use of vasoconstrictors might minimize venous congestion, replenish central blood flow, and thus optimize management of blood volume during a liver transplant operation...
January 28, 2016: World Journal of Gastroenterology: WJG
Emir Hoti, Aisling Hogan, Chris Hegarty, Olga Tucker, Donal Maguire, Justin Geoghegan, Oscar Traynor
The liver is the most frequently injured intra-abdominal organ and is the main cause of death in patients with abdominal injuries (mortality 10-15%). Grades III and IV liver injuries may present a complex problem to the surgeon. Several techniques to prevent exsanguination have been described including perihepatic packing, hepatic artery ligation, liver suturing or resection, and hepatectomy with transplantation. We report a case of a trauma patient who underwent perihepatic packing to control bleeding. Following pack removal, the patient developed severe cardiorespiratory depression resulting from postreperfusion syndrome requiring emergency total hepatectomy and liver transplantation...
June 2008: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Masaru Udagawa, Ben Tominaga, Daisuke Kobayashi, Yuuya Ishikawa, Shuuichi Watanabe, Rama Adikrisna, Hiroyuki Okamoto, Eiichi Yabata
We report a case of brain metastasis from rectal cancer a long time after the initial resection. A 62-year-old woman, diagnosed with lower rectal cancer with multiple synchronous liver and lung metastases, underwent abdominoperineal resection after preoperative radiochemotherapy (40 Gy at the pelvis, using the de Gramont regimen FL therapy: 1 kur). The histological diagnosis was a moderately differentiated adenocarcinoma. Various regimens of chemotherapy for unresectable and metastatic colorectal cancer were administered, and a partial response was obtained; thereby, the metastatic lesions became resectable...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
David C Madoff, Ron C Gaba, Charles N Weber, Timothy W I Clark, Wael E Saad
In recent decades, there have been numerous advances in the management of liver cancer, cirrhosis, and diabetes mellitus. Although these diseases are wide ranging in their clinical manifestations, each can potentially be treated by exploiting the blood flow dynamics within the portal venous system, and in some cases, adding cellular therapies. To aid in the management of these disease states, minimally invasive transcatheter portal venous interventions have been developed to improve the safety of major hepatic resection, to reduce the untoward effects of sequelae from end-stage liver disease, and to minimize the requirement of exogenously administered insulin for patients with diabetes mellitus...
February 2016: Radiology
Lin Wu, Lu Zhao, Ying Lu, Lan He, Xihong Hu
BACKGROUND: Congenital intrahepatic shunts in children are rare and precise treatment strategies have not been established. OBJECTIVE: The purpose of this study was to present our experience with transcatheter embolization in a descriptive case series of congenital intrahepatic shunts in children. MATERIALS AND METHODS: We retrospectively studied 10 children with symptomatic congenital intrahepatic shunts who were treated with embolization at our institute between January 2008 and December 2014...
April 2016: Pediatric Radiology
Tarun Kumar Jain, Rohit Kumar Phulsunga, Sunil Kumar, Ashwani Sood, Anish Bhattacharya, Bhagwant Rai Mittal
We present a 10-year-old boy having the bronchiectasis who was subjected to lung perfusion scintigraphy before lung resection surgery to assess the lung parenchymal function. It revealed unusual tracer distribution in right upper body that was mimicking to be liver. It was unusual unless there were some shunts bypassing the lung uptake or faulty radiopharmaceutical preparation. However by bringing down the image window, it became clear that radiopharmaceutical distribution was in thorax only correlating with lung uptake, and not in the liver...
October 2015: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Christoph Erxleben, Christian Scheurig-Münkler, Dominik Geisel, Bernd Hamm, Bernhard Gebauer, Maciej Janusz Powerski
BACKGROUND: Hepatopulmonary shunts (HPS) lead to radiation exposure of the lungs in patients undergoing radioembolization (RE) of malignant liver tumors. PURPOSE: To retrospectively analyze how HPS is affected by prior systemic or local therapy of the liver. MATERIAL AND METHODS: The percentage HPS was calculated from SPECT/CT scans obtained after technetium-99 m macroaggregated albumin administration into hepatic arteries in 316 patients evaluated for RE...
August 2016: Acta Radiologica
Vincenza Granata, Elisabetta de Lutio di Castelguidone, Roberta Fusco, Orlando Catalano, Mauro Piccirillo, Raffaele Palaia, Francesco Izzo, Adolfo D'Errico Gallipoli, Antonella Petrillo
OBJECTIVE: Irreversible electroporation (IRE) is a new ablation modality. Our purpose was to describe the effectiveness and the safety of the treatment and to evaluate the magnetic resonance imaging (MRI), computed tomography (CT) and contrast-enhanced ultrasound (CEUS) diagnostic accuracy in HCC patients treated with IRE at 1-, 3-, and 6-month follow-up. MATERIALS AND METHODS: In an 18-month period, we treated 24 HCC lesions in 20 patients unfit for surgery. MRI, CT and CEUS were performed before and one, 3 and 6 month after IRE...
February 2016: La Radiologia Medica
Lucio Urbani, Gianluca Masi, Marco Puccini, Piero Colombatto, Caterina Vivaldi, Riccardo Balestri, Antonio Marioni, Valerio Prosperi, Francesco Forfori, Gabriella Licitra, Chiara Leoni, Adriana Paolicchi, Piero Boraschi, Alessandro Lunardi, Carlo Tascini, Maura Castagna, Piero Buccianti
Major hepatectomy (MH) is often considered the only possible approach for colorectal liver metastasis (CRLM) at the hepato-caval confluence (CC), but it is associated with high morbidity and mortality. With the aim to reduce MH, we developed the "minor-but-complex" (MbC) technique, which consists in the resection of less than 3 adjacent liver segments with exposure of the CC and preservation of hepatic outflow until spontaneous maturation of peripheral intrahepatic shunts between main hepatic veins. We have evaluated applicability and outcome of MbC resections for the treatment of CRLM involving the CC...
July 2015: Medicine (Baltimore)
Daisuke Hokuto, Takeo Nomi, Ichiro Yamato, Satoshi Yasuda, Shinsaku Obara, Takatsugu Yamada, Hiromichi Kanehiro, Yoshiyuki Nakajima
Portal vein arterialization (PVA) has been applied as a salvage procedure in hepatopancreatobiliary surgeries, including transplantation and liver resection, with revascularization for malignancies. Here we describe the use PVA as a salvage procedure following accidental injury of the hepatic artery to the remnant liver occurred during left hepatic trisectionectomy for colorectal liver metastases (CRLM). A 60-year-old man with cancer of the sigmoid colon and initially unresectable CRLM received 11 cycles of hepatic arterial infusion chemotherapy with 5-fluorouracil (1500mg/week), after which CRLM was downstaged to resectable...
2015: International Journal of Surgery Case Reports
Fu-Qiang Wang, Qian Lu, Jun Yan, You-Yuan Peng, Cheng-Rong Xie, Yong-Jie Su, Jian-Yin Zhou, Bo-Liang Wang, Wen-Xiu Zhao, Xiao-Min Wang, Ping Bie, Zhen-Yu Yin
We previously reported the case of a 56-year-old male who underwent surgical treatment for gastric hepatoid adenocarcinoma and splenic metastasis. The present study reports the case of the same patient who underwent successful ex vivo hepatectomy and partial liver autotransplantation. Computed tomography scans demonstrated that the tumor was located in the left and caudate lobes of the liver, with hepatic vein and inferior vena cava involvement, and right portal vein compression. To clarify the association between the vessels and the tumor, a three-dimensional imaging technique was used to reconstruct the liver architecture...
May 2015: Oncology Letters
Mohamed T Ashour, Magdy Elsebae, Hussein Ezzat, Mohammed S Hedaya, Mohamed N H Taweela, Abdu Elbanna
Portal vein arterialization (PVA) is often referred to as a salvage procedure for insufficient arterial or portal inflow. Its main role focuses on two domains, liver transplantation and extensive surgery for malignancies of liver, biliary tract and pancreas. It ha been applied in treatment of fulminant hepatic failure due to intoxications and as a bridging procedure for transplantation or re-transplant. Radical resections with arterial reconstruction are a major challenge for surgeons especially in prolonging survival in advanced malignancies of the liver or biliary tract...
April 2015: Journal of the Egyptian Society of Parasitology
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