1/131. Prolonged recovery after extended right hepatic lobectomy in a patient with severe blunt liver injury and laceration of the vena cava. A report of case with special references to autotransfusion and complications of biliary decompression.A patient with severe blunt liver injury and laceration of the vena cava who underwent a successful extended right hepatic lobectomy is reported. The use of autotransfusion unit saved the patient from exsanguination. His postoperative course was complicated by renal and hepatic failure, bile leakage, and persistent jaundice due to cholangitis. Prolonged choledochal drainage via T-tube obviously acted as a source of infection. The use of autotransfusion, choledochal drainage and the proper timing of its removal, the treatment of vena cava lesions and jaundice due to cholangitis in patients with severe liver trauma are discussed.- - - - - - - - - - ranking = 1keywords = liver (Clic here for more details about this article) |
2/131. Severe jaundice in a gunshot casualty due to the coexistence of Dubin-Johnson and glucose-6-phosphate dehydrogenase deficiency.We report an unusual case of a 21-year-old man who was shot in his abdomen in the course of a robbery. He was previously diagnosed as glucose-6-phosphate dehydrogenase deficient. Mild icterus was noticed on admission to the emergency room. Exploratory laparotomy revealed a perforated ileal loop that was resected, and because the liver color was greenish black, a liver biopsy was performed during the operation. After operation the patient went through a severe icteric state that resolved spontaneously within a few days. Urinary coproporphyrin levels, along with compatible liver biopsy, confirmed the diagnosis of Dubin-Johnson disease. Severe hyperbilirubinemia after an abdominal injury is uncommon and is usually due to either a biliary duct injury or iatrogenic injury. This case presents an unusual cause of severe postoperative jaundice due to the rare coexistence of two inherited disorders.- - - - - - - - - - ranking = 0.5keywords = liver (Clic here for more details about this article) |
3/131. Acute jaundice in pregnancy: acute fatty liver or acute viral hepatitis?In this case, the difficulty in differential diagnosis between acute viral hepatitis and acute fatty liver of pregnancy was analyzed. These 2 conditions often raise controversal question regarding the decision making on emergency anesthesia for cesarean section to avert complications and optimize management. The dilemma in which an anesthesiologist is put is whether to promise the anesthesia straightaway in the face of a demonstrable acute jaundice in pregnancy to advise a postponement of surgery until a turn for the better. In this embarrassing situation, the authors suggest that a postpronement of surgery is rational to observe the development during which both the mother and the fetus should be closely monitored. Once the necessity of a cesarean section outweighs the benefit of transitional conservative treatment, it should be performed immediately.- - - - - - - - - - ranking = 3.7756798674363keywords = fatty liver, liver, fatty (Clic here for more details about this article) |
4/131. Rapidly progressive cholestasis: An unusual reaction to amoxicillin/clavulanic acid therapy in a child.Hepatotoxity associated with amoxicillin/clavulanic acid is usually a self-limited disease with complete recovery. We report a rapidly progressing liver disease with ductopenia and portal fibrosis in a 3-year-old boy treated with Augmentin.- - - - - - - - - - ranking = 0.16666666666667keywords = liver (Clic here for more details about this article) |
5/131. Pitfall: a pseudo tumor within the left liver lobe presenting with abdominal pain, jaundice and severe weight loss.A 51 year old male patient with a history of chronic alcohol consumption and recurrent pancreatitis was referred to our hospital with jaundice, epigastric pain, severe diarrhoea and weight loss of 28 kg within the last 12 months. A CT scan of the abdomen 4 months before admission had shown a pancreatitis with free fluid around the corpus and tail of the pancreas as well as dilated intrahepatic bile ducts and a cavernous transformation of the portal vein. Moreover, a tumor (3.5 x 3.0 x 3.6 cm) with irregular contrast enhancement was seen within the left liver lobe. The patient was referred to us for further evaluation and treatment. The initial B-Mode sonogram revealed a bull's eye like well defined lesion (8.1 x 7.5 x 7.0 cm) within the left liver lobe, consistent with a tumour or abscess. Prior to a diagnostic needle biopsy a PTCD was performed in this case presenting with dilated intrahepatic bile ducts and having a history of Billroth II operation. An additional colour coded Duplex Doppler ultrasonography demonstrated a visceral artery aneurysm and prevented us from performing the diagnostic puncture. The aneurysm was assumed to originate from a variant or a branch of the left hepatic artery. angiography revealed a pseudoaneurysm of the pancreaticoduodenal artery and coil embolization was performed because of the increasing size and the risk of a bleeding complication. Postinterventional colour duplex ultrasound measurement showed no blood flow within the aneurysm. Retrospectively, the pseudoaneurysm must have led to a compression of the common bile duct, since the patient did not develop cholestasis after embolization and removal of the PTCD. Thus, a pseudoaneurysm of the pancreaticoduodenal artery must be included in the differential diagnosis of liver tumours in patients with chronic pancreatitis, despite its unusual localization near the liver. Therefore, we suggest that colour coded ultrasonography should be applied to any unclear, bull's eye like lesion, even though this method alone cannot exactly determine the origin of the pseudoaneurysm. Interventional angiography remains the gold standard for the diagnosis and therapy of visceral artery aneurysm.- - - - - - - - - - ranking = 1.3333333333333keywords = liver (Clic here for more details about this article) |
6/131. liver failure with steatonecrosis after jejunoileal bypass: recovery with parenteral nutriton and reanastomosis.Two women, aged 41 and 51 years, developed jaundice, encephalopathy, and hypoprothrombinemia during rapid weight loss four and 12 months after jejunoileal bypass for refractory obesity. Both were treated for liver failure and received a prolonged course of nutrition parenterally and orally. Serial liver biopsy specimens demonstrated extensive alcoholic-like hepatitis and cirrhosis that improved with nutritional repletion and reanastomosis. Postoperative biopsy specimens later demonstrated minimal portal fibrosis in one patient and inactive mild cirrhosis in the other. Although previous reports indicate that patients usually die when they develop liver failure of this severity after jejunoileal bypass, prolonged intensive nutritional repletion was associated with sufficient clinical and histologic improvement in these two patients so that intestinal reanastomosis could be performed safely.- - - - - - - - - - ranking = 0.5keywords = liver (Clic here for more details about this article) |
7/131. trazodone-induced hepatotoxicity: a case report with comments on drug-induced hepatotoxicity.trazodone (Desyrel) is a second-generation, nontricyclic antidepressant that has been in use in north america since the early 1980s. It has the advantage of being more sedating and having less anticholinergic side effects than other secondary amines in the piperazine class, namely, desipramine and nortriptyline. Five previous cases of trazodone hepatotoxicity have been reported in the literature, one describing chronic damage and the others, more acute cellular and cholestatic injury. We describe a case of acute reversible liver injury with the use of trazodone. This case is unique in that injury occurred after protracted (18 months) drug use and while the patient was on corticosteroids. Moreover, the diagnosis was confirmed by an inadvertent challenge with trazodone. This case reports not only a well documented instance of trazodone-induced liver injury, but also serves as a basis for a brief discussion of mechanisms, clinical monitoring, and therapy in drug-induced hepatotoxicity.- - - - - - - - - - ranking = 0.33333333333333keywords = liver (Clic here for more details about this article) |
8/131. Clinics in diagnostic imaging (43). Right adrenal myelolipoma.A 53-year-old woman who presented with drug-induced jaundice and urinary tract infection was incidentally found to have a large abdominal mass. Radiographs and ultrasonography showed a large fatty mass located between the right lobe of the liver and the right kidney. diagnosis of right adrenal myelolipoma was made on computed tomography. The patient was treated conservatively. The causes of large fatty masses of the abdomen in adults are discussed, with emphasis on the imaging appearances of myelolipoma, renal angiomyolipoma, cystic teratoma and liposarcoma.- - - - - - - - - - ranking = 0.18471311500016keywords = liver, fatty (Clic here for more details about this article) |
9/131. jaundice caused by the vanishing bile duct syndrome in a child with Hodgkin lymphoma.The authors report a 5-year-old boy with hodgkin disease and cholestatic jaundice that predated the start of treatment for his lymphoma. His clinical course was punctuated by relentless progression of jaundice, characterized by obstructive pattern liver function tests, severe pruritus, intermittent fever, and marked hypercholesterolemia with development of palmar xanthomata. The jaundice was found to be attributable to vanishing bile duct syndrome (VBDS). The extent of hepatic dysfunction precluded appropriate treatment of the lymphoma with chemotherapy, and the boy died of liver failure. In the differential diagnosis of jaundice in children with hodgkin disease, VBDS should be considered.- - - - - - - - - - ranking = 0.33333333333333keywords = liver (Clic here for more details about this article) |
10/131. Acute lymphoblastic leukemia presenting with severe jaundice in an adult.We report an adult patient of acute lymphoblastic leukemia presenting with liver dysfunction.- - - - - - - - - - ranking = 0.16666666666667keywords = liver (Clic here for more details about this article) |
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