scholarly journals Multiple infarcted regenerative nodules in liver, spleen and kidney after gastric and oesophageal bleeding: A case report

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094239
Author(s):  
Anlong Wang ◽  
Yefei Shu
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Differential Diagnosis ◽  
Liver Cirrhosis ◽  
Abdominal Pain ◽  
Rare Condition ◽  
Sudden Onset ◽  
Gastric Bleeding ◽  
Regenerative Nodules ◽  
Hepatic Lesions

Infarcted regenerative nodules in a cirrhotic liver is a rare condition that may be confused with hepatocellular carcinoma on imaging. We report here a case of a 58-year-old man with live cirrhosis who presented with abdominal pain and distension and sudden onset of haematemesis. Computed tomography (CT) showed diffuse multinodular infarcted regenerative nodules and gastric bleeding. Physicians should include infarcted regenerative nodules in any differential diagnosis of multiple hepatic lesions in liver cirrhosis, particularly in patients with gastrointestinal varices.

scholarly journals Spontaneous Rupture of Hepatocellular Carcinoma in a Young Patient with Fatal Outcome

2018 ◽  
Vol 12 (1) ◽  
pp. 19-26 ◽  
Author(s):  
David F. Pinal-García ◽  
Carlos M. Nuño-Guzmán ◽  
Audrey Gómez-Abarca ◽  
Jorge L. Corona ◽  
Ismael Espejo
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Abdominal Pain ◽  
Young Patient ◽  
Spontaneous Rupture ◽  
Liver Tumors ◽  
Transarterial Embolization ◽  
Fatal Outcome ◽  
Noncirrhotic Liver

Spontaneous rupture of hepatocellular carcinoma (HCC) is a potentially life-threatening complication. Diagnosis may be difficult, particularly in the absence of known liver cirrhosis or tumor. A 20-year-old male patient presented with progressive abdominal pain and shock. His past medical history was uneventful. Anemia, acute renal failure, and abnormal liver function test were demonstrated. Mild hepatomegaly, perihepatic and flank fluid, and multiple hypodense liver lesions suggestive of intrahepatic metastases or multifocal HCC were revealed by computed tomography. Two actively bleeding liver tumors and multiple tumors in a noncirrhotic liver were found. Hemostatic suture and perihepatic packing were performed. The patient remained in critical condition, with a fatal outcome 48 h later. Histopathologic analysis reported HCC and absence of cirrhotic changes. HCC spontaneous rupture incidence is reported between 2.3 and 26%. Median age is 65 years. No liver cirrhosis is found in one-third of patients, with a median age of 51 years. Sudden onset of abdominal pain and shock is observed in the majority of cases. An accurate preoperative diagnosis improves to 75% with ultrasound and computed tomography. Besides hemodynamic stabilization, there is no general agreement on the best treatment option. Transarterial embolization, surgical perihepatic packing, suture plication, and hepatic artery ligation are useful methods of hemostasis in unstable patients. Mortality has been reported from 16.5 to 100%. The histopathologic finding of HCC in a noncirrhotic liver represents a less frequent presentation. A case of spontaneous rupture of HCC carcinoma and a noncirrhotic liver in a young patient is herein reported.

scholarly journals Etiology of Small Bowel Thickening on Computed Tomography

2012 ◽  
Vol 26 (12) ◽  
pp. 897-901 ◽  
Author(s):  
Lee Finkelstone ◽  
Ellen Wolf ◽  
Marjorie W Stein
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Medical Records ◽  
Final Diagnosis ◽  
Ct Scans ◽  
Common Cause ◽  
One Year

BACKGROUND: Abdominal pain is often evaluated using imaging, most often with computed tomography (CT). While CT is sensitive and specific for certain diagnoses, small bowel thickening is a nonspecific finding on CT with a broad differential diagnosis including infection, inflammation, ischemia and neoplasm.METHOD: A review of medical records of patients who underwent CT scans of the abdomen and pelvis over a one-year period and exhibited small bowel thickening were retrospectively evaluated to determine the final diagnosis.RESULTS: The etiologies of small bowel thickening on CT were as follows: infection (113 of 446 [25.34%]); reactive inflammation (69 of 446 [15.47%]); primary inflammation (62 of 446 [13.90%]); small bowel obstruction (38 of 446 [8.52%]); iatrogenic (33 of 446 [7.40%]); neoplastic (32 of 446 [7.17%]); ascites (30 of 446 [6.73%]); unknown (28 of 446 [6.28%]); ischemic (24 of 446 [5.38%]); and miscellaneous (17 of 446 [3.81%]).CONCLUSION: Infectious and inflammatory (primary or reactive) conditions were the most common cause of small bowel thickening in the present series; these data can be used to formulate a more specific differential diagnosis.

scholarly journals Magnetic resonance imaging of the cirrhotic liver: diagnosis of hepatocellular carcinoma and evaluation of response to treatment - Part 1

2017 ◽  
Vol 50 (1) ◽  
pp. 38-47 ◽  
Author(s):  
Miguel Ramalho ◽  
António P. Matos ◽  
Mamdoh AlObaidy ◽  
Fernanda Velloni ◽  
Ersan Altun ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Magnetic Resonance ◽  
Cirrhotic Liver ◽  
Response To Treatment ◽  
Arterial Phase ◽  
Resonance Imaging ◽  
Regenerative Nodules ◽  
Magnetic Resonance Imaging Mri

Abstract Magnetic resonance imaging (MRI) is the modern gold standard for the noninvasive evaluation of the cirrhotic liver. The combination of arterial phase hyperenhancement and delayed wash-out allows a definitive diagnosis of hepatocellular carcinoma (HCC) in patients with liver cirrhosis or chronic liver disease, without the requirement for confirmatory biopsy. That pattern is highly specific and has been endorsed in Western and Asian diagnostic guidelines. However, the sensitivity of the combination is relatively low for small HCCs. In this two-part review paper, we will address MRI of the cirrhotic liver. In this first part, we provide a brief background on liver cirrhosis and HCC, followed by descriptions of imaging surveillance of liver cirrhosis and the diagnostic performance of the different imaging modalities used in clinical settings. We then describe some of the requirements for the basic MRI technique, as well as the standard MRI protocol, and provide a detailed description of the appearance of various types of hepatocellular nodules encountered in the setting of the carcinogenic pathway in the cirrhotic liver, ranging from regenerative nodules to HCC.

scholarly journals Abdominal Pain and Vomiting in a Patient with Over-anticoagulation -- a Rare Case of Spontaneous Intramural Hematoma of the Jejunum

2020 ◽  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Vitamin K Antagonists ◽  
Intramural Hematoma ◽  
Rare Condition ◽  
The Body ◽  
Diagnostic Process ◽  
Tomography Scan

Anticoagulants, including vitamin K antagonists, are widely used for therapeutic and prophylactic purposes. Bleeding is the most important complication of anticoagulant therapy due to over-anticoagulation. Over-anticoagulation may present in unusual ways, such as spontaneous intramural hematoma of the small bowel. The classical clinical picture consists of abdominal pain, small bowel obstruction (that can present as vomiting) and hemorrhagic symptoms that can be related to the bowel or other parts of the body. Radiological examinations are essential for the diagnosis. Ultrasound can be helpful in the diagnostic process, but computed tomography is the procedure of choice. Conservative treatment is usually successful, including procedures that stop the over-anticoagulant consequences. A surgical approach is reserved for complications such as necrosis or perforation of the bowel. The diagnosis is definitively confirmed by the spontaneous resolution of the pathological findings on a follow-up computed tomography scan. We present a case of a 72-year-old woman who was diagnosed with this rare condition affecting the jejunum in the emergency department in our hospital.

scholarly journals Sorafenib, Risk of Bleeding and Spontaneous Rupture of Hepatocellular Carcinoma. A Clinical Case

2011 ◽  
Vol 54 (4) ◽  
pp. 177-179 ◽  
Author(s):  
Ferdinando Rombolà ◽  
Angelo Caravetta ◽  
Francesco Mollo ◽  
Antonio Spinoso ◽  
Lenino Peluso ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Abdominal Pain ◽  
Spontaneous Rupture ◽  
Clinical Case ◽  
Multikinase Inhibitor ◽  
Advanced Hcc ◽  
Risk Of Bleeding ◽  
Good General Condition ◽  
History Of

Spontaneous rupture is a rare and dramatic complication of hepatocellular carcinoma (HCC), burdened by a high mortality. Here we describe a case of a 73-year-old man, who arrived at the ER because of syncope, and acute epigastric and right upper quadrant abdominal pain. He had a history of hepatitis C-related liver cirrhosis and HCC in treatment with sorafenib. The physical examination showed a state of hemorrhagic anemia with the presence of blood in the peritoneal cavity. The patient underwent an urgent liver resection. Thirty days after surgery, he was in good general condition. Sorafenib is a multikinase inhibitor recently introduced in the therapy of patients with advanced HCC. Among the various side effects reported in patients treated with sorafenib, there is a higher risk of bleeding. In conclusion, sorafenib may increase the risk of bleeding and rupture of HCC in susceptible individuals.

THE WANDERING INTRA UTERINE DEVICE: A RARE CASE REPORT

2021 ◽  
pp. 40-41
Author(s):  
Nishant Lal ◽  
Gopika Vinayachandran ◽  
Shafy Ali Khan
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Rare Case ◽  
Sudden Onset ◽  
Organ Injury ◽  
Visceral Organ ◽  
Ileal Perforation ◽  
Abdominal Symptoms ◽  
Rare Case Report ◽  
Delayed Perforation

Intra Uterine Device (IUD) is one of the widely used reversible methods of female contraception. There are many complications reported with IUD insertion, among which device migration and delayed perforation of viscera like small bowel is one of the rare and serious complication. Here we report a case of 29 year old female who presented with sudden onset of abdominal pain associated with vomiting. Her Computed Tomography (CT) scan of abdomen revealed IUD lying within peritoneal cavity causing terminal ileal perforation. She was treated surgically and she recovered well. Extra uterine visceral organ injury many months or years following IUD insertion is rare and should be considered as a differential in any female with IUD presenting with abdominal symptoms.

scholarly journals Utility of the CT Scan in Diagnosing Midgut Volvulus in Patients with Chronic Abdominal Pain

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Ehsan Shahverdi ◽  
Mehdi Morshedi ◽  
Maryam Allahverdi Khani ◽  
Mohammad Baradaran Jamili ◽  
Fatemeh Shafizadeh Barmi
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Ct Scan ◽  
Mesenteric Artery ◽  
Chronic Abdominal Pain ◽  
Intestinal Malrotation ◽  
Midgut Volvulus ◽  
Common Complication ◽  
Preoperative Ct

Symptomatic intestinal malrotation first presenting in the adults is rare. Midgut volvulus is the most common complication of malrotation in the adults. Because of more differential diagnosis, Computed Tomography (CT) scan can play an important role in the evaluation of patients with this abnormality. The whirl pattern around the superior mesenteric artery found on CT scan in patients with midgut volvulus is pathognomonic and diagnostic. We describe a case of intestinal malrotation complicated by midgut volvulus in an adult patient. The preoperative CT findings were pathognomonic.

scholarly journals Reuse of a Pediatric Liver Graft: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
Koray Karabulut ◽  
Cengiz Eris ◽  
Turgut Piskin ◽  
Cuneyt Kayaalp ◽  
Sezai Yilmaz
Keyword(s):  
Hepatocellular Carcinoma ◽  
Interventional Radiology ◽  
Liver Cirrhosis ◽  
Abdominal Pain ◽  
Brain Death ◽  
Acute Abdominal Pain ◽  
Multiorgan Failure ◽  
Liver Graft ◽  
Liver Donor ◽  
Artery Thrombosis

We report the reuse of a liver graft after brain death of the first recipient. The liver donor was an 8-year-old male who died as a result of head injury. The graft was implanted first to a 4-year-old girl for fulminant hepatic failure. Unfortunately she developed progressive coma and brain death on fifth day of transplantation. The graft functions were normal, and reuse of the liver graft was planned. After informed consent, the graft was transplanted to a 31-year-old female recipient who has hepatocellular carcinoma with an underlying cryptogenic liver cirrhosis. The patient was discharged to home on 9th day after an uneventful postoperative period. However, she was readmitted to hospital with an acute abdominal pain 30 days after the operation. Hepatic artery thrombosis was diagnosed, and the attempt to open the artery by interventional radiology was unsuccessful. She died of sepsis and multiorgan failure on 37th posttransplant day.

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