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hepatic trauma

Laura Calsina Juscafresa, Maria Paramo Alfaro, Lukasz Grochowicz, Jose Ignacio Leal Lorenzo, Jose Ignacio Bilbao Jaureguizar
Aneurysms of the portal vein and its branches have been rarely described. Their natural history is unknown although large ones (>3cm in diameter) have been reported to cause rupture, thrombosis, duodenal or biliary obstruction, inferior vena cava compression and/or portal hypertension. We report the case of an incidentally diagnosed 4.5 cm splenic vein aneurysm repaired by endovascular treatment through a transhepatic route. The aneurysm was successfully excluded using a covered stent (Viabahn, Gore). The transhepatic route opens the possibility of offering a minimally invasive approach to vascular lesions of the portal vein system...
February 18, 2019: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Maxwell R Sirkin, Bethany M Heidenreich, Joshua C Dilday, Kathryn B Muir, Jason M Hiles, Luke J Hofmann
No abstract text is available yet for this article.
January 1, 2019: American Surgeon
Maxwell R Sirkin, Bethany M Heidenreich, Joshua C Dilday, Kathryn B Muir, Jason M Hiles, Luke J Hofmann
No abstract text is available yet for this article.
January 1, 2019: American Surgeon
Hui Gong, Xiaomin Sheng, Jianhua Xue, Dongbo Zhu
Severe trauma can result in secondary multiple organ dysfunction syndrome (MODS) and death. Inflammation response and oxidative stress promote the occurrence and development of MODS. TNFAIP3‑interacting protein 2 (TNIP2), which can repress the activation of nuclear factor‑κB (NF‑κB) and may be involved in MODS progression, has not been studied in regards to MODS. The present study aimed to investigate the expression, role and mechanism of TNIP2 in MODS following severe trauma. The expression level of TNIP2 was initially detected in the blood of patients with MODS using reverse transcription‑quantitative polymerase chain reaction and western blot assay...
January 24, 2019: Molecular Medicine Reports
Na Huang, Fan Pu Ji, Shu Zhang, Zhenzhen Li, Jun Li, Rui Zhou, Shaoying Zhang, Wei Wei, Liang Li, Haiyan Chen, Baohua Li, Guangyao Kong, Jun Yang, Zongfang Li
Our study aimed to investigate the histologic and immunological changes of portal hypertension (PH) pre- and postsplenectomy in hepatitis B virus (HBV)-related cirrhosis. Peripheral blood samples were obtained from 30 patients with HBV-related cirrhosis and PH at pre- and postsplenectomy time points and from 15 healthy subjects. Spleen tissue specimens were collected from 15 of the patients with HBV-related cirrhosis and from 8 control patients who had undergone splenectomy due to trauma. Immunohistochemical staining was performed to evaluate the immune effector cells and the expression of negative immune regulators...
January 24, 2019: Journal of Interferon & Cytokine Research
Laura Harrison, Dermot Gleeson
BACKGROUND: Initial treatment of autoimmune hepatitis (AIH) with prednisolone +/- azathioprine is based on randomised controlled trials. Many patients receive long-term immunosuppressive treatment to prevent disease relapse; this strategy has a weaker evidence base. AIM: To consider whether immunosuppressive treatment (IST) withdrawal in AIH is justified and to develop a rationale for patient selection. METHODS: We reviewed published papers between 1972-2018, which addressed the outcomes of IST withdrawal and/or complications of IST in AIH...
January 22, 2019: Liver International: Official Journal of the International Association for the Study of the Liver
Ryan Pereira, Tovi Vo, Kellee Slater
BACKGROUND: Extra-hepatic bile duct injuries (EHBDIs) are a rare consequence of blunt abdominal trauma. The purpose of this study was to establish mechanisms of injury, clinical indicators of EHBDI following blunt trauma (both with investigative modalities and intraoperatively), method and timing of injury detection, and definitive treatment options. METHOD: A Systematic Review was performed to gather data on patients with an extrahepatic bile duct injury secondary to blunt trauma...
January 8, 2019: Journal of Trauma and Acute Care Surgery
Sara Ibrahim, Thomas S Weiss
Liver regeneration is a well-orchestrated process that is triggered by tissue loss due to trauma or surgical resection and by hepatocellular death induced by toxins or viral infections. Due to the central role of the liver for body homeostasis, intensive research was conducted to identify factors that might contribute to hepatic growth and regeneration. Using a model of partial hepatectomy several factors including cytokines and growth factors that regulate this process were discovered. Among them, a protein was identified to specifically support liver regeneration and therefore was named ALR (Augmenter of Liver Regeneration)...
December 16, 2018: Cytokine & Growth Factor Reviews
F Virdis, I Reccia, S Di Saverio, G Tugnoli, S H Kwan, J Kumar, J Atzeni, M Podda
PURPOSE: This purpose of this systematic review was to determine the safety and efficacy of arterial embolization as the primary treatment for grade III-V liver trauma, excluding the postoperative use of arterial embolization. MATERIAL AND METHODS: A total of 24 studies published between January 2000 and June 2018 qualified for inclusion in this study. Four of them were prospective studies and 20 were retrospective. A total of 3855 patients (mean age, 33.5 years; range: 22-52...
December 13, 2018: Diagnostic and Interventional Imaging
Farahzad Janatmakan, Fatemeh Javaherforoosh Zadeh, Masomeh Alizadeh, Zeinab Alizadeh, Amin Bahreini
The alterations in liver function in patients after major liver resection are complex. Partial hepatectomy surgery is considered as a selective therapeutic approach in many benign and malignant liver tumors, secondary metastases, and liver trauma. According to surgical techniques most often based on vascular control and hepatic venous closure (Pringle maneuver), related complications such as ischemia and decreased venous return during and after surgery can be seen. In this study, the effects of Mannitol and N-acetylcysteine, on liver function, after hepatectomy surgery, were compared...
October 2018: Anesthesiology and Pain Medicine
Brian W Powers, Jiali Yan, Jingsan Zhu, Kristin A Linn, Sachin H Jain, Jennifer L Kowalski, Amol S Navathe
BACKGROUND: There is a growing focus on improving the quality and value of health care delivery for high-cost patients. Compared to fee-for-service Medicare, less is known about the clinical composition of high-cost Medicare Advantage populations. OBJECTIVE: To describe a high-cost Medicare Advantage population and identify clinically and operationally significant subgroups of patients. DESIGN: We used a density-based clustering algorithm to group high-cost patients (top 10% of spending) according to 161 distinct demographic, clinical, and claims-based variables...
December 3, 2018: Journal of General Internal Medicine
Yang Li, Liquan Tong, Jingyan Zhang, Yafeng Zhang, Feng Zhang
BACKGROUND/AIMS: Liver ischemia-reperfusion (I/R) injury is a pathological process that often occurs during liver and trauma surgery. There are numerous causes of liver I/R injury, but the mechanism is unknown. Galangin (GA) is a flavonoid, a polyphenolic compound widely distributed in medicinal herbs that has anti-inflammatory, antioxidant, and antitumor activity. This study evaluated the protective effect of GA on hepatic I/R injury. METHODS: An I/R model was created in male Wistar rats by clamping the hepatoportal vein, hepatic artery and hepatic duct for 30 min followed by reperfusion for 2 h...
November 27, 2018: Cellular Physiology and Biochemistry
Vincent Issac Lau, Fran Priestap, Joyce N H Lam, John Basmaji, Ian M Ball
PURPOSE: To describe factors (demographics and clinical characteristics) that predict patients who are at an increased risk of adverse events or unplanned return visits to a health-care facility following discharge direct to home (DDH) from intensive care units (ICUs). METHODS: Prospective cohort study of all adult patients who survived their stay in our medical-surgical-trauma ICU between February 2016 and 2017 and were discharged directly home. Patients were followed for 8 weeks postdischarge...
November 26, 2018: Journal of Intensive Care Medicine
Diego F Gallegos Chavez, Julia E Udaquiola, Roberto L Vagni, Pablo Lobos, Juan M Moldes, Daniel H Liberto
Hepatic and biliary tract injuries due to traumatic causes are rare in pediatric patients. Of the total number of patients with closed abdominal trauma, less than 9 % have liver injury, and the frequency varies between 2 and 3 % of biliary tract lesions. Currently, the recommended treatment for closed abdominal trauma with liver injury without hemodynamic repercussion is conservative. In case of presenting intra or extrahepatic biliary tract lesion, the preferred approaches are minimally invasive, such as percutaneous or endoscopic surgery, using laparotomy in selected cases...
December 1, 2018: Archivos Argentinos de Pediatría
Shohei Takaichi, Tsuyoshi Takahashi, Soichiro Funaki, Koji Tanaka, Yasuhiro Miyazaki, Tomoki Makino, Yukinori Kurokawa, Makoto Yamasaki, Kiyokazu Nakajima, Meinoshin Okumura, Masaki Mori, Yuichiro Doki
BACKGROUND: Diaphragmatic hernias (DH) are generally classified as either congenital or acquired. Acquired DH are generally of traumatic cause, being a rare complication after hepatectomy. Although repair of a DH can be performed via laparotomy, laparoscopy, or thoracoscopy, the use of laparoscopy is rare after hepatectomy owing to the formation of scar tissue. In this case, we describe our successful attempt at laparoscopic repair of a recurrent DH after hepatectomy. CASE PRESENTATION: A 30-year-old man underwent right hepatectomy for trauma and thoracotomy via the eighth intercostal space, with direct closure of the diaphragm by suturing...
November 19, 2018: Surgical Case Reports
Adam M Vogel, Jingwen Zhang, Patrick D Mauldin, Regan F Williams, Eunice Y Huang, Matthew T Santore, Kuojen Tsao, Richard A Falcone, M Sidney Dassinger, Jeffrey H Haynes, Martin L Blakely, Robert T Russell, Bindi J Naik-Mathuria, Shawn D St Peter, David Mooney, Jeffrey S Upperman, Christian J Streck
PURPOSE: To describe the practice pattern for routine laboratory and imaging assessment of children following blunt abdominal trauma (BAT). METHODS: Children (age < 16 years) presenting to 14 pediatric trauma centers following BAT over a 1-year period were prospectively identified. Injury, demographic, routine laboratory and imaging utilization data were collected. Descriptive, comparative, and correlation analysis was performed. RESULTS: 2188 children with a median age of 8 (4,12) years were included and the median injury severity score was 5 (1,10)...
November 13, 2018: Pediatric Surgery International
Benjamin E Curtis, Sally A Nofs, Megan Ahearne, Monica List, Matti Kiupel
A 19.5-y-old, male domestic yak ( Bos grunniens) with a history of sudden unexpected death was submitted for autopsy. The yak had hemoabdomen, and a large blood clot was attached to the liver and forestomachs. The hepatic artery had a saccular aneurysm with a 1-cm tear. The arterial wall at the site of the rupture was thin, and the luminal surface was roughened with yellow streaks. The arterial wall adjacent to the rupture was thickened, white, firm, and less elastic than normal arterial walls. Cause of death was concluded to be acute exsanguination...
November 2, 2018: Journal of Veterinary Diagnostic Investigation
Ayten Saracoglu, Kemal T Saracoglu
In this review article, we aimed to mainly review the principles for the management of hemostasis, changes that occur in the hemostatic system, and the techniques to reduce hemorrhage during liver transplantation. Hemostasis is a defense mechanism that may ensue from vascular damage and hemorrhage and consists of multiple phases which involve cellular and humoral elements of coagulation. In the presence of a cause, such as trauma-induced liver injury or hepatic failure that may trigger coagulopathy, the process becomes more problematic, and moreover, severe coagulation disorders may arise in daily practice unless the situation is intervened correctly and on time...
July 2018: Journal of Anaesthesiology, Clinical Pharmacology
Bella Smolen, Johad Khoury, Yaacov Baruch, Tarek Saadi
INTRODUCTION: Numerous conditions may cause liver lesions, solitary or multiple, benign or malignant. It can be crucial to establish the correct diagnosis. Splenosis is a rare condition that may result from the spillage of cells from the splenic pulp following abdominal trauma, accidental lesions to the spleen during operation or elective splenectomy. These splenic 'implants', which are often multiple, can be located anywhere in the peritoneal cavity, although they are most often found in the left upper quadrant of the abdomen...
October 31, 2018: Scottish Medical Journal
Alicia R Privette, Benjamin White, Pamela L Ferguson, E Douglas Norcross, Lauren E Richey
BACKGROUND: In the United States, millions of patients are living with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) (0.44% and 1.5%) and many are currently undiagnosed. Because highly effective treatments are now available, early identification of these patients is extremely important to achieve improved clinical outcomes. Prior data and trauma-associated risk factors suggest a higher prevalence of both diseases in the trauma population. We hypothesized that a screening program could be successfully initiated among trauma activation patients and that a referral and linkage-to-care program could be developed...
November 2018: Journal of Trauma and Acute Care Surgery
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