Anatomical and histological traits of Brycon amazonicus liver cultivated in a semi-intensive system

The work aimed to evaluate the weight-length relationship and the condition factor, characterizing the biometry, anatomy, histology and volumetric density of the liver of Brycon amazonicus, in different stages of body growth. The experiment used twenty specimens in four stages of body growth (PI, PII, PIII and PIV) harvested every 90 days, containing five specimens, each group. The livers were dissected, weighed (g) and processed routinely using the hematoxylin and eosin technique. The data were submitted to analysis of variance, Pearson’s correlation test and linear regression. The equation that represented the weight-length relation was W = 0.05902 x L2.63, with negative allometric growth, but with a relative condition factor equal to 1.0. The liver was divided into three lobes with the gallbladder close to the right lobe and its color varied from light red to dark red, not varying in relation to other fish species. The hepatosomatic relationship followed body growth until the PII group stage and then declined, demonstrating the behavior of its development in Brycon amazonicus. The organ consists predominantly of hepatocytes, followed by sinusoidal vessels and capillaries, with histological morphology similar to that of many species of fish. Melanomacrophage centers were found only in the most developed animals, but in small quantities, prompting the development of new research on this cell, in this species. In this way, research of this nature allows the characterization of fish species, helping to improve breeding methods, understanding pathological processes caused by diseases, and obtaining better productive capacity, serving an increasingly demanding and prosperous market.

A case report of COVID-19 evoked cholangitic liver abscess

Background Lately, the humanity has been being threatened by the coronavirus disease (COVID-19). The virus-related destructive motives can damage not only the lungs but also the brain, blood vessels, kidneys, and the heart. Case presentation A middle-aged female presented with jaundice post-COVID-19 pneumonia. The patient had past history of cholecystectomy 20 years ago. Both laboratory and imaging data revealed a picture of cholestasis with right lobe liver abscess. Despite drainage and culture-based antibiotics, no improvement ensued. Endoscopic retrograde cholangiopancreatography was done revealing mildly dilated common bile duct (CBD), multiple large stones, mildly dilated central biliary radicals, and an old overlooked stent inside the dilated CBD. Papillotomy and papilloplasty were undertaken followed by stones’ extraction with insertion of 2 plastic stents (10 cm× 10 f), and a flow of thick dark bile was inspected. The patient was finally improved and safely discharged. Conclusion Herein, we present the first case of long-retained quiescent biliary stent which was over-headed by a cholangitic abscess in the vicinity of COVID pneumonia.

The accuracy of Pleth Variability Index for directed fluid optimization in donors in living donor liver transplantation

Background Fluid management strongly affects hepatic resection and aims to reduce intraoperative bleeding during living donation. The Pleth Variability Index (PVI) is a tool to assess the fluid responsiveness from the pulse oximeter waveform; we evaluated the efficacy and accuracy of finger PVI compared to pulse pressure variation (PPV) from arterial waveform in predicting the fluid response in donor hepatectomy patients with the guide of non-invasive cardiac output (CO) measurements. We recruited forty patients who were candidates for right lobe hepatectomy for liver transplantation under conventional general anesthesia methods. During periods of intraoperative hypovolemia not affected by surgical manipulation, PVI, PPV, and CO were recorded then compared with definitive values after fluid bolus administration of 3–5 ml/kg aiming to give a 10% increase in CO which classified the patients into responders and non-responders. Results Both PPV and PVI showed a significant drop after fluid bolus dose (P < 0.001) leading to an increase of the CO (P < 0.0001), and the area under the curve was 0.934, 0.842 (95% confidence interval, 0.809 to 0.988, 0.692 to 0.938) and the standard error was 0.0336, 0.124, respectively. Pairwise comparison of PPV and PVI showed non-significant predictive value between the two variables (P = 0.4605); the difference between the two areas was 0.0921 (SE 0125 and 95% CI − 0.152 to 0.337). Conclusions PVI is an unreliable indicator for fluid response in low-risk donors undergoing right lobe hepatectomy compared to PPV. We need further studies with unbiased PVI monitors in order to implement a non-invasive and safe method for fluid responsiveness.

Adaptive morphogenesis of lamb liver under Anthropobiocenosis conditions lamb liver morphogenesis

Investigated the histological features of the structure of hepar of one-day-old lambs (ODL) using a complex of morphological techniques. It was found that hepar in ODL is formed by stroma and parenchyma. The stromal elements of the organ are formed by loose lugs of hematopoietic connective tissue, which in turn forms a capsule (2.80-7.23 microns thick), as well as the septa of the lobules, which include the hepar triads and paravasal tissue of efferent blood vessels. As a result of the studies, the prevalence of the stroma in the hematopoietic foci around large afferent blood vessels, especially in the hepar hilus, was revealed. The hepar parenchyma in ODL has structural incompleteness. It is formed by hepar cells and numerous resinusoidal cells located in the subcapsular, peripheral, central zones in the lobus hepatis. Hepar cells located in the subcapsular zone (SZ) have a more optically cleared (OC) cytoplasm, and the practically cleared cytoplasm of the hepatocyte diameter (HD) decreases towards the central zone (CZ). In the hepar parenchyma of the ODL, hematopoiesis foci (HF) are established in each of the lobes, which tend to decrease from the periphery to the center of the lobes. Hemopoetic cells (HC) are located between hepatocytes, densely layering on top of each other, and there are also cells located sparsely between the liver cells (LC). The number of hepatocytes per 1 mm2 of the area of the histological specimen in the left lobe (LL) of the ODL reaches the highest value 5983.79 ± 90.40, in the right lobe (RL) of the liver it is 5358.80 ± 646.60, while in the middle it has a minimum value and reaches 5133.10 ± 205.75.

Multiple Fat- Containing Hepatic Hydatid Cysts: A Case Report in The X- Ray Institute at Medical City Health Directorate in Iraq

Background: Hydatidosis is a zoonotic disease caused by Echinococcus granulosus and Echinococcus multilocularis parasite which is still endemic in many countries all over the world especially in the developing countries. The liver is the primary site to be infested by the parasite with a rate of 60 – 75%. The right lobe of the liver gets infected in about 80% of cases. Hydatid disease of the liver is usually asymptomatic and most cases discovered accidentally on routine clinical or radiological examinations for other illness. Symptoms usually appear in complicated cases either due to rupture, secondary bacterial infection, or due to the large size of the cyst which might cause pain in the right upper quadrant of the abdomen, discomfort, and sometimes swelling. In this case report, we reported the presence of fat globules within the hepatic hydatid cysts which is most probably due to rupture of hepatic hydatid cysts into the biliary tree. Keywords: Hepatic, hydatid cyst, fat globule and CT scan

Diagnosis and surgical treatment of liver echinococcosis

The results of treatment of 72 patients with echinococcosis of the liver were analyzed, women – 62 (86.2%), men – 10 (13.8%). Primary echinococcosis was detected in 69 (95.8%) patients, secondary – in 3 (4.2%). Among instrumental research methods, ultrasound and computed tomography examination were of diagnostic value. Single liver cysts were found in 63 (87.5%) patients, multiple – in 9 (12.5%). Among patients with solitary cysts, the right lobe was more often affected than the left – 48 (66.7%) vs 24 (33.3%) cases. Echinococcosis of central localization was less common and was noted in 8 (11.1%) cases. Echinococcosis complications were observed in 16 (22.2%) patients. Among them, most often there were suppurations of the cyst – in 13 (18.1%); a bursting of the cyst into the free abdominal cavity – in 1 (1.4%), in the pleural cavity – 1 (1.4%), in the biliary tract – in 1 (1.4%). Partial or complete liming of the hand was observed in 12 (16.7%) patients. In 20 (27.8%) cases, the operation was performed from the upper median access, in 42 (58.3%) – from oblique hypochondria accesses by Kocher or by Fedorov. Pericystectomy was performed in 48 (66.7%) patients, in 8 (11.1%) patients underwent resections of liver segments with an echinococcal cyst, in 4 (5.6%) – cyst opening with removal of contents and treatment of its cavity. Laparoscopic echinococectomy was used in 12 (16.7%) patients. In the postoperative period complications were observed in 16 (22.2%) patients. The use of the welding electrocoagulator EK-300M "Swarmed" in the thermal rehabilitation of the walls of the residual cavity after echinococectomy allowed to reduce blood loss from 2200±210 ml to 250±50 ml. With the use of laparoscopic echinococectomy, intraoperative blood loss was reduced by 9 times (р=0.0001); duration of operation – 2 times (р<0.05), stay in hospital – 3.3 times (р=0.002). There were no fatal outcomes. Before and after operation antirelapse antiparasitic therapy with albendazole (Vormil) was performed in two cycles of 28 days, separated by a 14-day break. The dose at body weight over 60 kg was 400 mg 2 times a day, and for less than 60 kg the drug was calculated at a rate of 15 mg/kg/day. There were 2 (2.8%) cases of relapse, there was no mortality.

P-L07 Nematode infection mimicking Liver metastasis from previous Melanoma

Background Malignant melanoma is known to metastasise to the liver. In the absence of any other disease spread it is prudent to resect these lesions. This case highlights how certain pathology can masquerade as liver metastases. Here we present a case of a gentleman previously diagnosed with malignant melanoma in 2016. He had previous liver resection for metastatic disease in 2017. Surveillance MRI picked up what was assumed to be a further metastatic deposit in the right lobe of the liver. Patient underwent resection, and subsequent histological analysis has shown this to be a worm cast from a parasitic infection. Methods Review of the current literature reveals just one previous case of nematode infection masquerading as liver metastasis making this a very unusual and rare finding at operation. We have undertaken review of patients imaging and histopathological specimens as well as seeking expert opinion from the infectious diseases centre in London Results Images were reviewed in HPB MDT and the suggestion was that this was a new malignant lesion in right lobe of liver. At time of operation the lesion had slightly odd appearance on USS. Specimen was sent for histological analysis and this showed no features to suggest malignant melanoma. On further examination there appeared to be a collection of hyalinised structures suspicious for parasitic infection. The specimen was sent to Guys for further evaluation. This confirmed that this was likely a helminth nematode resulting in a necrotic liver nodule Conclusions This presentation is highly unusual and review of the literature demonstrates only 1 previous case to date. The differential for liver lesions is broad and nematode infection should be included. However on a background of previous liver metastases it would not be high on the differential list. It is important that we consider this in future and ensure to clarify risk factors for nematode infection, none of which this patient had. Highlights that despite advancement in imaging it is still only after surgical resection we can be sure of the aetiology.

Laparoscopic S7 hepatectomy for hepatic mucinous neoplasm: a case report and literature review

Background Mucinous cystic neoplasm of the Liver is rare tumors with malignant potential that occur in the biliary epithelium. Because of its rare presentation, it is often misdiagnosed before surgery. Case presentation A 63-year-old female patient presented with intermittent upper abdominal pain for three months. Laparoscopic hepatectomy of Segment 7 was conducted based on the preoperative diagnosis of space-occupying lesion in the right lobe of the liver. Postoperative pathology showed a low-grade mucinous cystic neoplasm in the right posterior lobe of the liver. The preoperative CA19-9 level was significantly increased while the postoperative CA19-9 returned to the normal range. Conclusions The diagnosis of mucinous cystic neoplasm of the liver is closely related to the thickening of the cystic wall or the increase of CA19-9, which has great significance and deserves clinical attention.