scholarly journals Left hepatic lobe necrosis after laparoscopic treatment of a hiatal hernia

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Iulian Slavu ◽  
Socea Bogdan ◽  
Alecu Lucian
Keyword(s):  
Hiatal Hernia ◽  
Laparoscopic Approach ◽  
Left Lobe ◽  
Left Hepatic Lobe ◽  
Vascular Abnormalities ◽  
Hepatic Lobe ◽  
Gastrohepatic Ligament ◽  
Upper Abdominal ◽  
Abdominal Quadrant ◽  
Lobe Atrophy

The patient aged 66 years was admitted to the General Surgery Clinic for pain in the upper abdominal quadrant with posterior irradiation and weight loss. Two and a half years before the patient underwent surgery for a hiatal hernia when a Nissen fundoplication was performed by laparoscopic approach. CT was performed which confirmed the presence of a large abscess at the level of the left hepatic lobe and lobe atrophy (Figure no. 1, Figure no. 2). Surgery was undertaken. Abdominal exploration identified ischemia and necrosis of segments 2 and 3 of the liver so a resection was decided upon (Figure no. 3, Figure no 4). The postoperative evolution was favorable. NB: Ischemic necrosis of the left hepatic lobe most likely occurred after the surgical treatment of the hiatal hernia when the left hepatic artery was resected on dissection which was probably the only source of blood supply for the left lobe. It is important that these vascular abnormalities are known by the surgeon so during dissection of the gastrohepatic ligament any arteries identified should be protected to avoid a possible necrosis of the left hepatic lobe.

HELLP Syndrome Complicated Bile Duct Injury and Subsequent Left Hepatic Lobe Atrophy

2006 ◽  
Vol 51 (7) ◽  
pp. 1206-1212
Author(s):  
Ayse L. Mindikoglu ◽  
Shilun D. Li ◽  
Sherri L. Yong ◽  
Marc A. Borge ◽  
John Brems ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bile Duct Injury ◽  
Hellp Syndrome ◽  
Left Hepatic Lobe ◽  
Hepatic Lobe ◽  
Lobe Atrophy

Case 4.29

2014 ◽  
pp. 242-243
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Signal Intensity ◽  
High Signal Intensity ◽  
High Signal ◽  
Left Hepatic Lobe ◽  
Hepatic Lobe ◽  
Intensity Lesion ◽  
Gastrohepatic Ligament ◽  
Upper Abdomen ◽  
T2 Weighted Images

84-year-old woman who palpated a mass in her upper abdomen Coronal SSFSE images (Figure 4.29.1) demonstrate a large heterogeneous mass in the gastrohepatic ligament originating from the pancreas and displacing the stomach to the left. Note the high-signal-intensity lesion in the anterior left hepatic lobe. Axial fat-suppressed FSE T2-weighted images (...

scholarly journals Oesophagogastric invagination

2017 ◽  
Vol 99 (7) ◽  
pp. e202-e203
Author(s):  
J Zhang ◽  
Z Guan ◽  
P Zhang
Keyword(s):  
Rare Disease ◽  
Hiatal Hernia ◽  
Abdominal Discomfort ◽  
Sliding Hiatal Hernia ◽  
Upper Abdominal

Oesophagogastric invagination is a relatively rare disease that is primarily caused by a sliding hiatal hernia. We report a successfully treated case of oesophagogastric invagination caused by achalasia. Oesophagogastric invagination should be considered in patients complaining of upper abdominal discomfort.

Redo Surgery after Failure of Antireflux Surgery

2018 ◽  
Vol 84 (11) ◽  
pp. 1819-1824 ◽  
Author(s):  
Alberto Vilar ◽  
Pablo Priego ◽  
Ana Puerta ◽  
Marta Cuadrado ◽  
Francisco GarcÍA Angarita ◽  
...  
Keyword(s):  
Hiatal Hernia ◽  
Laparoscopic Approach ◽  
Long Term Results ◽  
Complication Rates ◽  
Open Approach ◽  
Redo Surgery ◽  
Primary Surgery ◽  
Satisfactory Outcome ◽  
Symptomatic Outcome ◽  
Recurrent Hiatal Hernia

Surgery for refractory gastroesophageal reflux disease (GERD) has a satisfactory outcome for most patients; however, sometimes redo surgery is required. The Outcome and morbidity of a redo are suggested to be less successful than those of primary surgery. The aim of this study was to describe our experience, long-term results, and complications in redo surgery. From 2000 to 2016, 765 patients were operated on for GERD at our hospital. A retrospective analysis of 56 patients (7.3%) who underwent redo surgery was conducted. Large symptomatic recurrent hiatal hernia (50%) and dysphagia (28.6%) were the most frequent indications for redo. An open approach was chosen in 64.5 per cent of patients. Intraoperative and postoperative complication rates were 18 per cent and 14.3 per cent, respectively. Mortality rate was 1.8 per cent. Symptomatic outcome was successful in 71.3 per cent. Patients reoperated because of dysphagia and large recurrent hiatal hernia had a significantly higher failure rate (32.3% and 31.2%, respectively; P = 0.001). Complication rate was significantly lower in the laparoscopic group (0% vs 22.2%; P = 0.04). There were no statistical differences between expert and nonexpert surgeons. Laparoscopic approach has increased to 83.3 per cent in the last five years. Symptomatic outcome after redo surgery was less satisfactory than that after primary surgery. Complications were lower if a minimally invasive surgical approach was used.

Metastasis of missed cholangiocarcinoma in the left lobethrough abdominal wall laparoscopic port-site and umbilicus after laparoscopic cholecystectomy: case report and literature review

2020 ◽  
Author(s):  
Lesheng Huang ◽  
Hongyi Li ◽  
Jun Chen ◽  
Jinghua Jiang ◽  
Wanchun Zhang ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Abdominal Wall ◽  
Malignant Tumor ◽  
Malignant Tumors ◽  
Abdominal Cavity ◽  
Left Lobe ◽  
Port Site ◽  
Laparoscopic Port ◽  
Missed Diagnosis ◽  
Upper Abdominal

Abstract Introduction: Laparoscopic cholecystectomy (LC) has been widely used by surgeons. However, a serious but rare condition may be happened, which is the missed diagnosis of intraperitoneal malignant tumor. If the malignancy exists, the changes of the abdominal environment or the laparoscopic operation might brought the cancer cells to the abdominal cavity or the abdominal wall. The missed laparoscopic malignant tumors are prone to metastasis, especially at the laparoscopic port-site. More extreme condition will be located in the navel, which is known as Sister Mary Joseph’s nodule(SMJN).Case presentation: A 63-year-old female who had undergone cholecystectomy and choledocholithotomy ten months ago was hospitalized for upper abdominal pain. Laboratory examination indicated that the most of tumor markers were increased. CT scan revealed that there was a diffused irregular and progressively enhanced mass around the left lobe bile duct, multiple enlarged lymph nodes in the abdominal cavity and multiple nodular lesions were found under the costal margin of the right upper abdominal wall, right lower abdominal wall and the umbilicus. Biopsy of the nodules under the original surgical scar showed an infiltrative or metastatic middle differentiated adenocarcinoma. So the diagnosis was left lobe cholangiocarcinoma of the liver, multiple lymph nodes metastasis in the abdominal cavity and multiple implant metastasis in abdominal wall laparoscopic port-site and umbilical.Conclusion: In laparoscopic cholecystectomy, surgeons should not only focus on the local lesions, like gallstone in biliary system, but also look around other the tissues and organs to avoid missing the abdominal malignant tumor or other lesions. When atypical symptoms or abnormalities have been found pre-operation, all abdominal organs should be evaluated in detail to avoid missed diagnosis of potential malignant tumors. On the other hand, when there is a nodule in the umbilicus, all the organs and tissues in abdomen should be examined to find the potential malignant tumor. Finally, multiple cholelithiasis in the left lobe of the liver should be regarded as a high risk factor for cholangiocarcinoma.

Case 2.12

2014 ◽  
pp. 83-84
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Left Hepatic Lobe ◽  
Axial Diffusion ◽  
Hepatic Lobe ◽  
Diffusion Weighted ◽  
Systemic Disorder

34-year-old woman with a systemic disorder Coronal SSFSE (Figure 2.12.1), axial fat-suppressed T2-weighted FSE (Figure 2.12.2), and axial diffusion-weighted (b=100 s/mm2) (Figure 2.12.3) images demonstrate hepatomegaly with multiple small hyperintense nodules predominantly involving the left hepatic lobe. Axial arterial (...

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