scholarly journals Hepatic Rupture Induced by Spontaneous Intrahepatic Hematoma

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Jin-bao Zhou ◽  
Wei-bo Chen ◽  
Feng Zhu
Keyword(s):  
Lupus Erythematosus ◽  
Vena Cava ◽  
Caudate Lobe ◽  
Posterior Lobe ◽  
Hepatic Rupture ◽  
Arterial Bleeding ◽  
Daily Dose ◽  
History Of ◽  
Upper Abdominal ◽  
The Right

The etiology of hepatic rupture is usually secondary to trauma, and hepatic rupture induced by spontaneous intrahepatic hematoma is clinically rare. We describe here a 61-year-old female patient who was transferred to our hospital with hepatic rupture induced by spontaneous intrahepatic hematoma. The patient had no history of trauma and had a history of systemic lupus erythematosus for five years, taking a daily dose of 5 mg prednisone for treatment. The patients experienced durative blunt acute right upper abdominal pain one day after satiation, which aggravated in two hours, accompanied by dizziness and sweating. Preoperative diagnosis was rupture of the liver mass. Laparotomy revealed 2500 mL fluid consisting of a mixture of blood and clot in the peritoneal cavity. A 3.5 cm × 2.5 cm rupture was discovered on the hepatic caudate lobe near the vena cava with active arterial bleeding, and a 5  × 6 cm hematoma was reached on the right posterior lobe of the liver. Abdominal computed tomography (CT) and laparotomy revealed spontaneous rupture of intrahepatic hematoma with hemorrhagic shock. The patient was successfully managed by suturing the rupture of the hepatic caudate lobe and clearing part of the hematoma. The postoperative course was uneventful, and the patient was discharged after two weeks of hospitalization.

scholarly journals A case of antiphospholipid syndrome presenting cryptogenically as Budd-Chiari syndrome, then fulminantly as Libman-Sacks endocarditis

2019 ◽  
Vol 12 (5) ◽  
pp. e227450
Author(s):  
Hart A Goldhar ◽  
Paloma O’Meara ◽  
Lana A Castellucci
Keyword(s):  
Antiphospholipid Syndrome ◽  
Lupus Erythematosus ◽  
Vena Cava ◽  
Left Middle Cerebral Artery ◽  
Severe Thrombocytopenia ◽  
Budd Chiari Syndrome ◽  
Reactive Protein ◽  
Chiari Syndrome ◽  
History Of ◽  
New Diagnosis

A 58 year-old left-handed woman was transferred to our hospital with an evolving left middle cerebral artery stroke, severe thrombocytopenia and elevated inflammatory markers. She had a history of chronic Budd-Chiari syndrome (BCS) 16 months prior, attributed to a calcified web in the inferior vena cava that was stented. No thrombophilia testing was performed at that time. The current presentation demonstrated dense right-sided facial and arm paresis and neglect. Erythrocyte sedimentation rate and C-reactive protein were elevated, an autoimmune workup was consistent with a new diagnosis of systemic lupus erythematosus and triple-positive antiphospholipid antibodies. A transesophageal echocardiogram demonstrated a vegetation consistent with Libman-Sacks endocarditis (LSE), thought to have embolised to the brain. The patient was treated acutely with steroids, intravenous immunoglobulin and clopidogrel. This case demonstrates an atypical constellation of the antiphospholipid syndrome, with a novel presentation of BCS and LSE, and reinforces the importance of hypercoagulability screening in this population.

scholarly journals Hemopericardium and Cardiac Tamponade Secondary to Migrated Inferior Vena Cava Filter

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Jeet J. Mehta ◽  
Benjamin DeMarco ◽  
John P. Vavalle ◽  
Khola S. Tahir ◽  
Joseph S. Rossi
Keyword(s):  
Inferior Vena Cava ◽  
Cardiogenic Shock ◽  
Cardiac Tamponade ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Filter Placement ◽  
History Of ◽  
The Right

A 73-year-old female presented with cardiogenic shock secondary to hemopericardium and cardiac tamponade. Imaging revealed two fractured legs of an inferior vena cava filter, with one leg within the anterior myocardium of the right ventricle and another penetrating the inferior septum through the middle cardiac vein. Hemopericardium and cardiac tamponade were treated with pericardiocentesis. A multidisciplinary meeting resulted in deferring further action against the embedded fractured legs of the filter with consideration of the patient’s age and comorbidities. This case report should alert clinicians to think about hemopericardium as a cause of cardiac tamponade and cardiogenic shock in a patient with a history of an inferior vena cava filter placement.

scholarly journals Multiple Thromboses in a Patient with Systemic Lupus Erythematosus after Splenectomy

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Deng-Ho Yang
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Vena Cava ◽  
Fetal Loss ◽  
Pulse Therapy ◽  
Multiple Organ ◽  
Renal Infarction ◽  
Systemic Lupus ◽  
Adequate Treatment ◽  
History Of

Antiphospholipid syndrome is a disorder presenting with arterial or venous thrombus and a history of fetal loss. Early diagnosis and adequate treatment is important to prevent multiple organ failures. Here, we described a woman with a two-year history of systemic lupus erythematosus with severe nephrotic syndrome, manifested multiple thrombi over the portal vein and the inferior vena cava, combined with acute renal infarction. The patient underwent splenectomy 10 months ago. Initially, she received anticoagulant treatment and low-dose glucocorticoid, but multiple organ failure progressed. After emergency plasma exchange followed by glucocorticoid pulse therapy, the patient recovered.

scholarly journals Bullous Systemic Lupus Erythematosus Associated with Esophagitis Dissecans Superficialis

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Meera Yogarajah ◽  
Bhradeev Sivasambu ◽  
Eric A. Jaffe
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Skin Lesions ◽  
Esophageal Mucosa ◽  
Systemic Lupus ◽  
Neck Lymph Node ◽  
The Face ◽  
History Of ◽  
The Right ◽  
Pruritic Skin

Bullous systemic lupus erythematosus is one of the rare autoantibody mediated skin manifestation of systemic lupus erythematosus (SLE) demonstrating subepidermal blistering with neutrophilic infiltrate histologically. We present a case of a 40-year-old Hispanic female who presented with a several months’ history of multiple blistering pruritic skin lesions involving the face and trunk, a photosensitive rash over the face and neck, swelling of the right neck lymph node, and joint pain involving her elbows and wrist. Her malady was diagnosed as bullous systemic lupus erythematosus based on the immunological workup and biopsy of her skin lesions. The patient also complained of odynophagia and endoscopy revealed esophagitis dissecans superficialis which is a rare endoscopic finding characterized by sloughing of the esophageal mucosa. The bullous disorders typically associated with esophagitis dissecans superficialis are pemphigus and rarely bullous pemphigoid. However, this is the first reported case of bullous systemic lupus erythematosus associated with esophagitis dissecans superficialis.

scholarly journals The Adventitia Resection in Treatment of Liver Hydatid Cyst: A Case Report of a 15-Year-Old Boy

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Zhenhua Ma ◽  
Wei Yang ◽  
Yingmin Yao ◽  
Qingguang Liu
Keyword(s):  
Hydatid Cyst ◽  
Bile Leakage ◽  
Virtual Space ◽  
Liver Hydatid Cyst ◽  
Computed Tomographic ◽  
History Of ◽  
Right Lobe ◽  
Upper Abdominal ◽  
The Right ◽  
Significant Health

Human hydatid disease is a significant health problem in endemic regions caused by the larval form ofEchinococcus granulosus. In this paper, we report a case of liver hydatid cyst. The patient, a 15-year-old boy, presented with a history of intermittent upper abdominal pain of a few-month duration was referred to our hospital for investigation. Computed tomographic scan and laboratory test suggested a hydatid cyst in the right lobe of liver. The adventitia resection of hydatid cyst was smoothly performed as there was a less bloody virtual space between adventitia and outer membrane. Our diagnosis was made using an imaging approach and was confirmed during surgery. We proposed the adventitia resection of hydatid cyst could be safe and easy to perform with low risk of bleeding and bile leakage.

scholarly journals Atypical Presentation of Central Venous Occlusion (CVO) Disease

2019 ◽  
Vol 9 (1) ◽  
pp. 268-270
Author(s):  
Rosnelifaizur R*,Aizat Sabri I, Krishna K,Lenny SS,Azim I, H Harunarashid
Keyword(s):  
Superior Vena ◽  
Vena Cava ◽  
Lymphatic Vessels ◽  
Venous Access ◽  
Venous Occlusion ◽  
Intermittent Fever ◽  
Fluid Analysis ◽  
History Of ◽  
The Right ◽  
End Stage

We reported a case of 58 years old gentleman who known case of end stage renal failure and had history of Right IJC cannulation of venous access on 2012, presented with recurrent shortness of breath, chesty cough and intermittent fever. Otherwise he got no hemoptysis, no recent contact with PTB patients and no joint pain. The same presentation occurred last month with a pleural tapping was done and claimed it was a milky content. No further investigation was done at that moment. This current presentation noted a dullness in percussion up to midzone of right lung and reduce air entry on auscultation as well. The pigtail catheter was inserted over the right pleural space and it was confirmed as a chylothorax with a present of cholesterol in a pleural fluid analysis. Computed tomography of the thorax showed complete occlusion of the superior vena cava with an established collateral circulation. Lymphangiogram revealed lipiodol seen opacified lymph node and lymphatic vessels until the level of T3 on the right and T5 on the left. There was no obvious lipiodol opacification seen at the region of the right thorax. Effusion was improved after the instillation of fibrinolytic agent and the the chest radiograph shows improvement.

scholarly journals The center of the human porta hepatis

Medicina ◽  
2008 ◽  
Vol 44 (9) ◽  
pp. 694
Author(s):  
Saulius Rutkauskas ◽  
Vytautas Gedrimas ◽  
Tomas Čičinskas ◽  
Aurimas Savulis ◽  
Algidas Basevičius
Keyword(s):  
Vena Cava ◽  
Caudate Lobe ◽  
Left Lobe ◽  
Porta Hepatis ◽  
Liver Lobe ◽  
Anatomical Structures ◽  
Liver Surface ◽  
Right Lobe ◽  
Human Livers ◽  
The Right

Majority of interventional procedures are made at the porta hepatis, which has a different location on the visceral surface of the liver. Objective. To describe the location of the porta hepatis in respect of the borders of the visceral surface and separate lobes of the liver. Material and methods. Sixty-four human livers were obtained at autopsy (mean age, 45 years). We chose the point of the crossing of longitudinal and transversal lines of the porta hepatis, which was considered as center of the porta hepatis. The distances from the center of the porta hepatis to the border of the visceral surface every 10 degrees with protractor and ruler and the angles of anatomical structures were measured. Additionally, the borders of lobes were assessed. Results. We found that center of the porta hepatis is located approximately 11.6±2.8 cm from the border of the visceral liver surface. The location of center of the porta hepatis was 11.6±1.1 cm from the border of left lobe, 9.7±1.5 cm from the border of quadrate lobe, 12.3±1.2 cm from the border of right lobe, and 7.4±1.0 cm from the border of caudate lobe. All distances were statistically significant (P<0.05). An angle of the fissure for round ligament was 50.5°, of the fossa of gallbladder – 102°, of the groove of vena cava inferior – 266°, and of the fissure for ligamentum venosum – 293°. The borders of the right, left, quadrate, and caudate liver lobe covered 45.6%, 32.6%, 14.3%, and 7.5% of the perimeter of visceral surface border, respectively. Conclusions. The center of the porta hepatis can help to characterize precisely the position of the porta hepatis on the visceral surface of the liver.

Enterocutaneous fistula secondary to retained intraperitoneal fragment of a ventriculoperitoneal shunt in a 48-year-old man with spina bifida

2021 ◽  
Vol 14 (4) ◽  
pp. e240634
Author(s):  
Andrew Webster ◽  
Rishabh Singh ◽  
John Stebbing
Keyword(s):  
Spina Bifida ◽  
Enterocutaneous Fistula ◽  
Vp Shunt ◽  
Surgical Department ◽  
History Of ◽  
Delayed Complications ◽  
Upper Abdominal ◽  
The Right ◽  
Abdominal Quadrant

We report the case of a 48-year-old man with spina bifida and history of previous ventriculoperitoneal (VP) shunt placement for hydrocephalus. On attempted removal of the shunt 2 years prior to presentation at a neurosurgical unit, the peritoneal component was left in situ due to difficulties with removal. He presented acutely to our general surgical department with an enterocutaneous fistula precipitated by the retained fragment discharging to the right upper abdominal quadrant that required urgent surgical intervention. Although abdominal complications of VP shunts are documented, there is minimal literature as to the risks of remnant catheters being left in situ. This case demonstrates the possible risks with retained VP shunt catheters and the necessity to remove any redundant foreign bodies to prevent significant delayed complications.

scholarly journals Periesophageal Pseudoaneurysms: Rare Cause of Refractory Bleeding Treated with Transarterial Embolization

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Divyanshoo R. Kohli ◽  
Rachit D. Shah ◽  
Daniel J. Komorowski ◽  
George B. Smallfield
Keyword(s):  
Lupus Erythematosus ◽  
Transarterial Embolization ◽  
Left Gastric Artery ◽  
Massive Bleeding ◽  
Upper Gastrointestinal Endoscopy ◽  
Angiographic Embolization ◽  
First Case ◽  
Arterial Bleeding ◽  
History Of ◽  
Upper Gastrointestinal

A 43-year-old female with history of systemic lupus erythematosus, prior cytomegalovirus esophagitis treated with ganciclovir, and long segment Barrett’s esophagus (Prague class C8 M9) with high grade dysplasia treated with radiofrequency ablation presented to the hospital with hematemesis. An upper gastrointestinal endoscopy showed multiple esophageal ulcers with active arterial spurting which could not be controlled with endoscopic interventions including placement of hemostatic clips. An emergent angiogram demonstrated actively bleeding saccular dilations (pseudoaneurysms) in the esophageal branches of the lower thoracic aorta as well as left gastric artery for which gelfoam and coil embolization was initially successful. Due to recurrence of massive bleeding, she subsequently underwent emergent esophagectomy and bipolar exclusion. Pathology demonstrated submucosal hemorrhage, esophagitis with dysplastic Barrett’s mucosa, and an ulcer containing cytomegaloviral inclusions. We report the first case of arterial bleeding from periesophageal pseudoaneurysms as well as use of angiographic embolization for arterial bleeding in the esophagus.

scholarly journals Primary squamous cell carcinoma of the liver: a case report

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110212
Author(s):  
Yu Sun ◽  
Guangyu Jin
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Imaging Features ◽  
Primary Squamous Cell Carcinoma ◽  
History Of ◽  
Loss Of Appetite ◽  
Upper Abdominal ◽  
The Right ◽  
Abdominal Quadrant

Primary squamous cell carcinoma of the liver is extremely rare, very difficult to diagnose, and carries an extremely poor prognosis. In this study, we discuss the imaging features of a patient with primary hepatic squamous cell carcinoma. The patient was admitted to hospital owing to discomfort in the right upper abdominal quadrant and a loss of appetite. He had no previous risk factors associated with hepatic squamous cell carcinoma and no history of systemic squamous cell carcinoma. We diagnosed primary hepatic squamous cell carcinoma by pathological analysis. Primary hepatic squamous cell carcinoma is rare, and its histological features are controversial, which makes the clinical and imaging diagnosis difficult. Therefore, it is urgent to improve the understanding of this disease in clinical practice to avoid misdiagnosis, and to identify the best treatment. This case provides a basis for the clinical diagnosis of primary hepatic squamous cell carcinoma.

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