Perinephric Abscess due to Spontaneous Perforation of the Right Hepatic Duct - An ERCP Diagnosis

Endoscopy ◽  
1989 ◽  
Vol 21 (02) ◽  
pp. 108-109
Author(s):  
I. Dobó ◽  
I. Bozaly ◽  
I. Szántó ◽  
J. Banai ◽  
M. Kun
Keyword(s):  
Hepatic Duct ◽  
Spontaneous Perforation ◽  
Perinephric Abscess ◽  
The Right

scholarly journals Extraluminal recanalization for postoperative biliary obstruction using transseptal needle

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hiroki Horinouchi ◽  
Eisuke Ueshima ◽  
Keitaro Sofue ◽  
Shohei Komatsu ◽  
Takuya Okada ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Bile Duct ◽  
Biliary Obstruction ◽  
Hepatic Duct ◽  
Drainage Tube ◽  
Biliary Strictures ◽  
Hepatic Bile ◽  
Hepatic Bile Duct ◽  
Benign Biliary Strictures ◽  
The Right

Abstract Background Postoperative biliary strictures are commonly related to accidental bile duct injuries or occur at the site of biliary anastomosis. The first-line treatment for benign biliary strictures is endoscopic therapy, which is less invasive and repeatable. However, recanalization for biliary complete obstruction is technically challenging to treat. The present report describes a successful case of treatment by extraluminal recanalization for postoperative biliary obstruction using a transseptal needle. Case presentation A 66-year-old woman had undergone caudal lobectomy for the treatment of hepatocellular carcinoma. The posterior segmental branch of the bile duct was injured and repaired intraoperatively. Three months after the surgery, the patient had developed biliary leakage from the right hepatic bile duct, resulting in complete biliary obstruction. Since intraluminal recanalization with conventional endoscopic and percutaneous approaches with a guidewire failed, extraluminal recanalization using a transseptal needle with an internal lumen via percutaneous approach was performed under fluoroscopic guidance. The left lateral inferior segmental duct was punctured, and an 8-F transseptal sheath was introduced into the ostium of right hepatic duct. A transseptal needle was advanced, and the right hepatic duct was punctured by targeting an inflated balloon that was placed at the end of the obstructed right hepatic bile duct. After confirming successful puncture using contrast agent injected through the internal lumen of the needle, a 0.014-in. guidewire was advanced into the right hepatic duct. Finally, an 8.5-F internal–external biliary drainage tube was successfully placed without complications. One month after the procedure, the drainage tube was replaced with a 10.2-F drainage tube to dilate the created tract. Subsequent endoscopic internalization was performed 5 months after the procedure. At the 1-year follow-up examination, there was no sign of biliary obstruction and recurrence of hepatocellular carcinoma. Conclusions Recanalization using a transseptal needle can be an alternative technique for rigid biliary obstruction when conventional techniques fail.

scholarly journals A case of right hepatic duct entering cystic duct successfully treated by laparoscopic subtotal cholecystectomy through preoperatively placed biliary stent

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hiroki Hirao ◽  
HiroHisa Okabe ◽  
Daisuke Ogawa ◽  
Daisuke Kuroda ◽  
Katsunobu Taki ◽  
...  
Keyword(s):  
Cystic Duct ◽  
Hepatic Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Endoscopic Retrograde ◽  
Case Presentation ◽  
Endoscopic Nasobiliary Drainage ◽  
Subtotal Cholecystectomy ◽  
Upper Abdominal ◽  
The Right ◽  
Nasobiliary Drainage

Abstract Background Laparoscopic cholecystectomy is a well-established surgical procedure and is one of the most commonly performed gastroenterological surgeries. Therefore, strategy for the management of rare anomalous cystic ducts should be determined. Case presentation A 56-year-old woman was admitted to our hospital owing to upper abdominal pain and diagnosed with acute cholecystitis. Magnetic resonance cholangiopancreatography suspected that several small stones in gallbladder and the right hepatic duct drained into the cystic duct. Endoscopic retrograde cholangiopancreatography confirmed the cystic duct anomaly, and an endoscopic nasobiliary drainage catheter (ENBD) was placed at the right hepatic duct preoperatively. Intraoperative cholangiography with ENBD confirmed the place of division in the gallbladder, and laparoscopic subtotal cholecystectomy was safely performed. Conclusions The present case exhibited rare right hepatic duct anomaly draining into the cystic duct, which might have caused biliary tract disorientation and bile duct injury (BDI) intraoperatively. Any surgical technique without awareness of this anomaly preoperatively might insufficiently prevent BDI, and preoperative ENBD would facilitate safe and successful surgery.

scholarly journals Anatomic Variations of the Right Hepatic Duct: Results and Surgical Implications from a Cadaveric Study

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Theodoros Mariolis-Sapsakos ◽  
Vasileios Kalles ◽  
Konstantinos Papatheodorou ◽  
Nikolaos Goutas ◽  
Ioannis Papapanagiotou ◽  
...  
Keyword(s):  
Bile Ducts ◽  
Hepatic Duct ◽  
Anatomical Variations ◽  
Common Hepatic Duct ◽  
Drainage Pattern ◽  
Left Hepatic Duct ◽  
Surgical Interventions ◽  
Drainage Patterns ◽  
The Common ◽  
The Right

Purpose. Thorough understanding of biliary anatomy is required when performing surgical interventions in the hepatobiliary system. This study describes the anatomical variations of right bile ducts in terms of branching and drainage patterns, and determines their frequency. Methods. We studied 73 samples of cadaveric material, focusing on the relationship of the right anterior and posterior segmental branches, the way they form the right hepatic duct, and the main variations of their drainage pattern. Results. The anatomy of the right hepatic duct was typical in 65.75% of samples. Ectopic drainage of the right anterior duct into the common hepatic duct was found in 15.07% and triple confluence in 9.59%. Ectopic drainage of the right posterior duct into the common hepatic duct was discovered in 2.74% and ectopic drainage of the right posterior duct into the left hepatic duct in 4.11%. Ectopic drainage of the right anterior duct into the left hepatic ductal system and ectopic drainage of the right posterior duct into the cystic duct was found in 1.37%. Conclusion. The branching pattern of the right hepatic duct was atypical in 34.25% of cases. Thus, knowledge of the anatomical variations of the extrahepatic bile ducts is important in many surgical cases.

scholarly journals A rare cause of biliary obstruction – intraductal neuroendocrine tumor of the right hepatic biliary duct: a case report

2020 ◽  
Author(s):  
Mirela Danila ◽  
Roxana Sirli ◽  
Alina Popescu ◽  
Nicoleta Iacob ◽  
Ana-Maria Ghiuchici
Keyword(s):  
Neuroendocrine Tumors ◽  
Biliary Obstruction ◽  
Ultrasound Examination ◽  
Hepatic Duct ◽  
Biliary Duct ◽  
Presumptive Diagnosis ◽  
Additional Imaging ◽  
Biliary Ducts ◽  
Well Differentiated ◽  
The Right

Primary biliary tract neuroendocrine tumors (NETs) are extremely rare tumors that account for 0.2-2% of all gastrointestinal neuroendocrine tumors. The typical presentation is with jaundice and other symptoms related to biliary obstruction.We present a case of right hepatic duct NET in a 27-year-old female patient, asymptomatic, presented for a routine ultrasound examination that revealed moderate dilatation of the intrahepatic biliary ducts and a 20 mm hyperechoic lesion in the right hepatic biliary duct. Additional imaging was performed with the presumptive diagnosis of cholangiocarcinoma. After surgery, the histopathological and immunohistochemical report was conclusive for the diagnosis of G2 well-differentiated NET

Coronal 2D MR cholangiography overestimates the length of the right hepatic duct in liver transplantation donors

2016 ◽  
Vol 27 (5) ◽  
pp. 1822-1830 ◽  
Author(s):  
Bohyun Kim ◽  
Kyoung Won Kim ◽  
So Yeon Kim ◽  
So Hyun Park ◽  
Jeongjin Lee ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatic Duct ◽  
Mr Cholangiography ◽  
The Right

scholarly journals Biliary Stent Migration to Hepatic Duct–Case Report of a Late Complication

2015 ◽  
Vol 8 ◽  
pp. CCRep.S18975
Author(s):  
Amir Houshang Mohammad Alizadeh ◽  
Kianoush Donboli ◽  
Mehran Khodakarami ◽  
Salar Baghbani ◽  
Mohammad Reza Zali
Keyword(s):  
Abdominal Pain ◽  
Hepatic Duct ◽  
Late Complication ◽  
Stent Migration ◽  
Biliary Stent ◽  
Plastic Stents ◽  
Plastic Stent ◽  
Polypectomy Snare ◽  
Endoscopic Retrieval ◽  
The Right

Endoscopic retrieval of proximally migrated biliary plastic stents may be technically challenging and sometimes unsuccessful. Here we report the case of a 59-year-old woman with a migrated biliary stent in the right hepatic duct, which was diagnosed after the patient presented with cholangitis. The patient presented with constant abdominal pain in the right upper quadrant lasting for two days, along with nausea and bilious vomiting. The stent was retrieved by a polypectomy snare after failure of biliary basket and forceps. We performed a novel procedure for extraction of a migrated plastic stent, by using a polypectomy snare.

scholarly journals A Rare Devastating Complication of Lasik: Bilateral Fungal Keratitis

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
H. Taylan Sekeroglu ◽  
E. Erdem ◽  
K. Yar ◽  
M. Yağmur ◽  
T. R. Ersoz ◽  
...  
Keyword(s):  
Unusual Case ◽  
Fungal Keratitis ◽  
Clinical Suspicion ◽  
Laser In Situ Keratomileusis ◽  
Spontaneous Perforation ◽  
Corneal Ulceration ◽  
Bilateral Involvement ◽  
The Right ◽  
Visual Results

Purpose. To report an unusual case of severe bilateral fungal keratitis following laser in situ keratomileusis (LASIK).Method. A 48-year-old man developed bilateral diffuse corneal infiltration two weeks after LASIK. The corneal scrapings revealed fungal filaments but cultures were negative.Results. The corneal ulceration was improved on the left eye whereas spontaneous perforation occurred and finally evisceration was needed on the right eye despite topical and systemic antifungal treatment.Conclusions. Fungal keratitis, especially with bilateral involvement, is a very rare and serious complication of LASIK surgery. Clinical suspicion is crucial because most of fungal keratitis are misdiagnosed as bacterial keratitis and can lead serious visual results, even eye loss.

scholarly journals Right Hepatic Artery: A Cadaver Investigation and Its Clinical Significance

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Usha Dandekar ◽  
Kundankumar Dandekar ◽  
Sushama Chavan
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Hepatic Artery ◽  
Hepatic Duct ◽  
Common Hepatic Duct ◽  
Normal Anatomy ◽  
Surgical Safety ◽  
Right Hepatic Artery ◽  
The Common ◽  
The Right

The right hepatic artery is an end artery and contributes sole arterial supply to right lobe of the liver. Misinterpretation of normal anatomy and anatomical variations of the right hepatic artery contribute to the major intraoperative mishaps and complications in hepatobiliary surgery. The frequency of inadvertent or iatrogenic hepatobiliary vascular injury rises with the event of an aberrant anatomy. This descriptive study was carried out to document the normal anatomy and different variations of right hepatic artery to contribute to existing knowledge of right hepatic artery to improve surgical safety. This study conducted on 60 cadavers revealed aberrant replaced right hepatic artery in 18.3% and aberrant accessory right hepatic artery in 3.4%. Considering the course, the right hepatic artery ran outside Calot’s triangle in 5% of cases and caterpillar hump right hepatic artery was seen in 13.3% of cases. The right hepatic artery (normal and aberrant) crossed anteriorly to the common hepatic duct in 8.3% and posteriorly to it in 71.6%. It has posterior relations with the common bile duct in 16.7% while in 3.4% it did not cross the common hepatic duct or common bile duct. The knowledge of such anomalies is important since their awareness will decrease morbidity and help to keep away from a number of surgical complications.

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