1/138. Hepatic sarcoidosis complicated by hepatocellular carcinoma.A case of a 63-year-old man with a long-standing history of portal hypertension secondary to hepatic sarcoidosis who developed hepatocellular carcinoma is reported.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
2/138. Portal hypertension due to extensive hepatic cysts in autosomal dominant polycystic kidney disease.Liver cysts are a well-recognized feature of autosomal dominant polycystic kidney disease (ADPKD) and occur in 77% of patients more than 60 years old. Serious sequelae, however, are rare, the two most common complications being pain and cyst infections. Portal hypertension has been reported in ADPKD due to the rare presence of congenital hepatic fibrosis. We report a case of ADPKD in a patient who had portal hypertension due to distortion of portal vein and venules by extensive hepatic cysts.- - - - - - - - - - ranking = 6keywords = hypertension (Clic here for more details about this article) |
3/138. Successful use of clopidogrel for cerebrovascular accident in a patient with suspected ticlopidine-induced hepatotoxicity.OBJECTIVE: To report a case of successful clopidogrel use in a patient who developed suspected ticlopidine-induced hepatotoxicity during therapy for a cerebrovascular accident. CASE REPORT: A 79-year-old white woman with a history of hypertension, type 2 diabetes, alzheimer disease, and coronary artery disease started receiving ticlopidine 250 mg twice daily three days after hospital admission for a cerebrovascular accident. Medications prior to admission included quinapril, furosemide, insulin, atorvastatin, conjugated estrogen, medroxyprogesterone, donepezil, and vitamin e. The estrogen, medroxyprogesterone, and donepezil were discontinued on admission. Laboratory tests on admission revealed that total bilirubin, alkaline phosphatase, and aspartate aminotransferase (AST) were within normal limits. On day 39 of hospitalization, laboratory tests showed marked increases in alkaline phosphatase, AST, alanine aminotransferase, gamma-glutamyl-transferase, and 5' nucleotidase. physical examination revealed no signs of jaundice or hepatomegaly, and laboratory tests for viral hepatitis were negative. A presumptive diagnosis of ticlopidine-induced hepatotoxicity was made and ticlopidine was discontinued. The following day, clopidogrel 75 mg/d was initiated. liver function tests returned to baseline over the following four months with ongoing clopidogrel therapy. DISCUSSION: ticlopidine-induced hepatotoxicity is well documented in the literature. In the present case, clopidogrel, a structurally similar thienopyridine, was substituted for ticlopidine following the development of presumptive ticlopidine-induced hepatotoxicity. serum liver enzyme concentrations returned to baseline with continued clopidogrel therapy, suggesting that clopidogrel is a suitable alternative in patients who develop ticlopidine-induced hepatotoxicity. CONCLUSIONS: Clopidogrel may be a suitable alternative for patients who develop ticlopidine-induced hepatotoxicity.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
4/138. The experience of endoscopic tissue glue injection in the treatment of hepatic sarcoidosis related gastric variceal bleeding: report of a case.A case of hepatic sarcoidosis complicated with portal hypertension and gastric variceal bleeding is described. A 53 year-old male suffered from persistent fever and massive hematemesis. Acute gastric variceal bleeding was diagnosed. Endoscopic tissue glue injection stopped this acute episode and ablated the varices after another two sessions of endoscopic tissue glue injection treatment. Subsequent administration of corticosteroids improved the symptoms and liver function. This was probably the first case of hepatic sarcoidosis associated with gastric variceal bleeding which was successfully treated by endoscopic tissue glue injection to be reported.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
5/138. Post-surgical shunt hepatopulmonary syndrome in a case of non-cirrhotic portal hypertension: lack of efficacy of shunt reversal.hepatopulmonary syndrome, a consequence of significant liver disease and portal hypertension, is thought to be secondary to the effects of vasoactive substances, normally inactivated in the liver, on the pulmonary vasculature. We report a patient with preserved hepatic function who underwent a decompressive surgical porto-systemic shunt for non-cirrhotic portal hypertension. This patient developed hepatopulmonary syndrome with dyspnoea and oxygen desaturation 2 years post-surgical shunt. Over the next 7 years, the patient's respiratory function became increasingly impaired although hepatic function remained preserved. Because of the hypothesized role of porto-systemic shunting in the aetiology of this syndrome, the surgical shunt was successfully reversed angiographically. No improvement in dyspnoea or oxygen saturation occurred and liver transplantation was undertaken. Six months post-transplant, the patient has decreased his oxygen requirements and is free of dyspnoea. Our experience supports the causal role of porto-systemic shunting in the pathogenesis of hepatopulmonary syndrome but suggests that merely decreasing the extent of porto-systemic shunting is not beneficial. liver transplantation remains the only reliable therapeutic modality available to these patients.- - - - - - - - - - ranking = 6keywords = hypertension (Clic here for more details about this article) |
6/138. Nodular regenerative hyperplasia of the liver: case report of a 13-year-old girl and review of the literature.BACKGROUND: Nodular regenerative hyperplasia (NRH) of the liver is a multi-acinar regenerative nodular lesion in a non-cirrhotic liver. It is a rare entity, especially in children, and remains of unknown aetiology. OBJECTIVE: NRH is often seen in association with other diseases or drug intake. In half of patients it is complicated by portal hypertension. Radiologically, its nodular appearance may look like neoplasia. RESULTS: We report a case of NRH with enormous hepatomegaly and multiple huge nodules. CONCLUSION: We wish to emphasise the importance of open wedge biopsy to establish diagnosis, since the prognosis of NRH in the absence of portal hypertension is good. Complications such as rupture of a nodule are rare.- - - - - - - - - - ranking = 2keywords = hypertension (Clic here for more details about this article) |
7/138. Portosystemic shunting in patients with primary biliary cirrhosis: a good risk disease.Five patients with primary biliary cirrhosis underwent portosystemic shunting for the control of variceal bleeding. Three procedures were emergencies and two were elective. There was no operative mortality; all patients were followed until the present or until death. One patient is alive 4 years and another, 2 years postoperatively. One patient died 4 years after operation and another died 16 months postoperatively. Another patient survived for 8 years following her shunt and eventually died as a result of a cerebrovascular accident. This group of patients is compared to a larger group undergoing portosystemic shunting because of portal hypertension secondary to other forms of liver disease. The absence of operative mortality and the fact that several of these patients had moderately long postoperative survival despite apparently poor liver function suggest that the usual criteria for the assessment of operative risk are not valid in primary biliary cirrhosis.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
8/138. Esophageal varices in Felty's syndrome: A case report and review of the literature.A case of upper gastrointestinal tract hemorrhage secondary to esophageal varices in a patient with Felty's syndrome prompted a review of the pathogenesis and treatment of this condition. Six previously reported cases of this association were found. The clinical picture is that of long-standing rheumatoid arthritis with severe articular and extraarticular manifestations including splenomegaly, depression of the blood elements, mild liver function abnormalities, portal hypertension without cirrhosis or portal vein obstruction, an elevated splenic blood flow, and a reduction in portal hypertension by simple splenectomy. The presence of portal hypertension with varices may be another indication of splenectomy in patients with Felty's syndrome.- - - - - - - - - - ranking = 3keywords = hypertension (Clic here for more details about this article) |
9/138. Pulmonary hypertension as a result of asymptomatic portosystemic shunt.This report describes a patient with severe pulmonary hypertension accompanied by a congenital intrahepatic portosystemic shunt. Primary pulmonary hypertension was suspected initially because none of the classic symptoms of a portosystemic shunt were present. physicians should note that disorders of the portal system may cause pulmonary hypertension even in the absence of symptoms suggesting liver disease.- - - - - - - - - - ranking = 7keywords = hypertension (Clic here for more details about this article) |
10/138. Solitary hepatic abscess with associated glomerulonephritis in a neonate.A full-term neonate with a history of umbilical venous catheterization followed by coagulase-negative staphylococcal sepsis is presented. The infant developed a solitary hepatic abscess with saprophytic organisms. Her liver abscess resulted in acute glomerulonephritis characterized by hypertension, proteinuria, oliguria, and azotemia. Surgical drainage and antibiotic treatment of the abscess was associated with resolution of the glomerulonephritis. glomerulonephritis due to solitary liver abscess in a neonate has not been reported previously. Acute onset of glomerulonephritis should prompt a search for occult sources of infection.- - - - - - - - - - ranking = 1keywords = hypertension (Clic here for more details about this article) |
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