Single hepatocellular carcinomas (HCCs) larger than 4 cm usually occur in the right liver lobe in the absence of cirrhosis

AbstractHepatocellular carcinoma is one of the most common liver tumours. At the time of diagnosis, only 20% of patients are suitable for liver resection for curative purposes. In patients who are not suitable for surgical resection, chemoembolization of the hepatic artery is a viable therapeutic option. We present the case of a 60-year-old male patient being admitted with a diagnosis of liver tumour in the right liver lobe. Abdominal angio-CT examination revealed the existence of a tumour formation of 9x10 cm in the liver segments IV, VIII. Given the large size of the tumour, as well as the patient’s comorbidities, it was decided to practice hepatic chemoembolization with Irinotecan. The clinical evolution was favourable, the patient being discharged 48 hours after the intervention. Hepatic transarterial chemoembolization is a viable alternative in the treatment of patients with unresectable hepatocellular carcinomas, which may improve the prognosis of these patients.

Download Full-text

Single hepatocellular carcinomas larger than 4 CM mainly occur in the right liver lobe in the absence of cirrhosis or viral disease

Journal of Hepatology ◽

10.1016/s0168-8278(02)80297-5 ◽

2002 ◽

Vol 36 ◽

pp. 86

Author(s):

Michele Zuckermann ◽

Francesco Cetta ◽

Maria Teresa Del Vecchio ◽

Loreta Pergola ◽

Monica Piccini ◽

...

Keyword(s):

Viral Disease ◽

Liver Lobe ◽

Hepatocellular Carcinomas ◽

The Right

Download Full-text

Noninvasive assessment of oesophageal varices presence and size in patients with liver cirrhosis using right liver lobe/serum albumin concentration

Vojnosanitetski pregled ◽

10.2298/vsp0707453a ◽

2007 ◽

Vol 64 (7) ◽

pp. 453-457

Author(s):

Tamara Alempijevic ◽

Vladislava Bulat ◽

Nada Kovacevic ◽

Rada Jesic ◽

Srdjan Djuranovic ◽

...

Keyword(s):

Liver Cirrhosis ◽

Portal Hypertension ◽

Oesophageal Varices ◽

Digestive Endoscopy ◽

Liver Lobe ◽

Albumin Ratio ◽

Cirrhotic Patients ◽

The Mean ◽

Upper Digestive Endoscopy ◽

The Right

Background/Aim. Liver cirrhosis is a chronic, progressive disease and it is usually accompanied by portal hypertension. The development of oesophageal varices (OV) is one of the major complications of portal hypertension. Cirrhotic patients should be screened for the presence of OV when portal hypertension is diagnosed. In order to reduce the increasing burden that endoscopy units have to bear, some studies have attempted to identify parameters for noninvasive prediction of OV presence. The aim of our study was to evaluate the value of biochemical and ultrasonography parameters for prediction of OV presence. Methods. This study included 58 cirrhotic patients who underwent a complete biochemical workup, ultrasonography examination and upper digestive endoscopy. Right liver lobe diameter/albumin ratio was calculated and its correlation to the presence and degree of OV, and Child-Pugh score of liver cirrhosis explored. Results. The mean age of the patients included in the study was 53.07?13.09 years; 40 were males and 18 females. In the Child-Pugh class A were 53.4% patients, class B 39.7%, whereas 6.9% were in the class C. In 24.1% of the patients no OV were identified by upper digestive endoscopy, 19% had OV grade I, 34.5% grade II, 20.7% grade III, and 1.7% OV grade IV. The mean value of the right liver lobe diameter/ albumin ratio was 5.43?1.79 (range of 2.76?11.44). Statistically significant correlation (p < 0.01) was confirm by Spearman's test between OV grade and calculated index (? = 0.441). Conclusion. The right liver lobe diameter/albumin ratio is a noninvasive parameter which provides an accurate information pertinent to the determination of OV presence and their grading in patients with liver cirrhosis. .

Download Full-text

Case of primary hepatic leiomyosarcoma successfully treated with laparoscopic right hepatectomy

BMJ Case Reports ◽

10.1136/bcr-2019-233567 ◽

2020 ◽

Vol 13 (2) ◽

pp. e233567 ◽

Cited By ~ 1

Author(s):

Stephanie Vella ◽

Kelvin Cortis ◽

David Pisani ◽

James Pocock ◽

Luca Aldrighetti

Keyword(s):

Physical Examination ◽

Surgical Resection ◽

Epigastric Pain ◽

Large Mass ◽

Disease Recurrence ◽

Right Hepatectomy ◽

Liver Lobe ◽

Laparoscopic Right Hepatectomy ◽

The Right

We describe the case of a 77-year-old woman, presenting with non-specific epigastric pain. Physical examination and subsequent imaging revealed the presence of a large mass in the right liver lobe. This was shown to be a leiomyosarcoma on biopsy histology. Further investigation confirmed this to be a primary hepatic leiomyosarcoma with no evidence of metastases. The patient underwent successful surgical resection. She is currently under imaging follow-up, with no evidence of disease recurrence.

Download Full-text

Biliobronchial fistula due to hydatidosis of the liver and choledocholithiasis

Medicinski pregled ◽

10.2298/mpns0906281b ◽

2009 ◽

Vol 62 (5-6) ◽

pp. 281-284 ◽

Cited By ~ 1

Author(s):

Dragoljub Bilanovic ◽

Darko Zdravkovic ◽

Borisav Toskovic

Keyword(s):

Bile Ducts ◽

Hepatic Duct ◽

Liver Cyst ◽

Bronchial Tree ◽

Liver Lobe ◽

X Ray ◽

Abdominal Approach ◽

Chest X Ray ◽

The Right ◽

And Control

INTRODUCTION Biliobronchial fistula (BBF) is an abnormal communication between the biliary system and bronchial tree due to trauma, hemiheptectomy benign biliary stricture with cholangitis and necrotic hepatic infections such as hydatid disease. Intratoracic rupture of a hydatis cyst of the liver is a rare but severe complication with an incidence about 1% and mortality rate about 10%. CASE REPORT A 50-year-old male patient presented with cough, episodes of biliary expectoration and haemoptysis followed with fever, fatigue and dyspnea. The diagnosis was set by echosonography, Chest x-ray finding, CT scan, bronchoscope aspirates while bronchography did not show results. The surgery was done through right subcostal laparotomy. A hydatid cyst was found in the right liver lobe its diameter being 10 cm, fixed with diaphragm. Intraoperative cholangiography revealed choledocholithiasis (two calculi), dilatation of bile ducts and communication of right hepatic duct with the irregular liver cavity as well as with the bronchi of the right lower pulmonary lobe. Cholecystectomy, choledocholitotomy with drainage lavage of bile ducts pericystectomy and cyst evacuation was performed, followed by diaphragm necrosectomy. The postoperative period and control cholangiography through T drain were normal. DISCUSSION The surgical treatment has five goals: to treat the liver cyst, secure free biliary drainage, perform hepatodiaphragmatic disconection, solve intratoracic lesion and restore ti diaphragm. We believe these goals could be achieved through abdominal approach except for irreversible bronchiectasis, intratoracal collection and chronic pulmonary sepsis. CONCLUSION In any case, a surgery still remains the treatment of choice in cases of echinococcosis. Most cases can be solved by laparo-tomy.

Download Full-text

The center of the human porta hepatis

Medicina ◽

10.3390/medicina44090089 ◽

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.

Download Full-text

Ultrasonographic examination of liver and spleen of normal adult spiti horses and Himalayan Hill mules of India

Indian Journal of Animal Research ◽

10.18805/ijar.b-3409 ◽

2017 ◽

Author(s):

Uiase Bin Farooq ◽

Adarsh Kumar ◽

Rajni Chaudhary

Keyword(s):

Blood Vessels ◽

Abdominal Cavity ◽

Left Lobe ◽

Dynamic Parameters ◽

Liver Lobe ◽

Abdominal Ultrasonography ◽

Ultrasonographic Examination ◽

Splenic Parenchyma ◽

Right Lobe ◽

The Right

The main objective of this study was to develop baseline topographical data of landmarks for locating liver and spleen and to generate sonographic calliper measurements along with dynamic parameters of these organs. Abdominal ultrasonography was performed on 50 native adult (Spiti horses and Himalayan hill mules) healthy unsedated equines of either sex. The thickness, character and echo-architecture of liver and spleen were recorded. In horses, the right lobe of liver was found from 8th to 15th intercostal space (ICS) and left lobe from 6th to 11th (±1) ICS, while in mules the right liver lobe was found between 6th to 15th (±1) ICS and left lobe between 6th to 9th (±1) ICS. The liver was recognized by its branching vasculature and architecture was found relatively homogenous. In addition ventral edges were distinctly sharp. Spleen was found from 8th to 17th ICS both in horses as well as in mules. The splenic parenchyma was homogenously granular in appearance with few blood vessels and most echogenic organ in the abdominal cavity of equines. The only measurement that was reliably obtained was the central thickness or depth of the spleen, which varied from 41.4 to 68.4 mm (Mean± SE= 50.84±4.61 mm) in horses and 37.9 to 51.6 mm (Mean± SE = 42.76±2.34 mm) in mules. Therefore detailed ultrasonographic examination of liver and spleen helped us to compile baseline data, which will be helpful in management of the affections of liver and spleen in future.

Download Full-text