scholarly journals An unusual cause of eosinophilic pleural effusion and migrating biliary stenosis: Strongyloides stercoralis infection in a young immunocompetent man

2019 ◽  
Vol 13 (2) ◽  
pp. 116-120
Author(s):  
Elisa Paolucci ◽  
Eva Tonveronachi ◽  
Chiara Praticò ◽  
Maria Cristina Zani ◽  
Maria Cristina Paonessa ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Hepatic Duct ◽  
Imaging Techniques ◽  
Strongyloides Stercoralis ◽  
Left Hepatic Duct ◽  
Positive Stool ◽  
Peritoneal Effusion ◽  
Positive Stool Sample ◽  
The Right ◽  
Eosinophilic Pleural Effusion

We present the case of a 33-year-old Italian man who came to our attention for epigastralgia associated with polyserositis (pleural, pericardial, and peritoneal effusion with the involvement of the Douglas excavation), in the absence of a significant medical history. Laboratory analysis revealed exudative eosinophilic pleural effusion; serial imaging techniques showed a transient stenosis of the right hepatic duct and a subsequent stenosis of the left hepatic duct. After several negative serological investigations, a positive anti-strongyloides immunoglobulin G antibodies titer rose suspicions of Strongyloides infection, which was confirmed by positive stool sample for parasite. Ivermectin-therapy was started and the patient has fully recovered.

scholarly journals Klatskin-Mimicking Lesions

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1944
Author(s):  
Marinko Marušić ◽  
Matej Paić ◽  
Mia Knobloch ◽  
Marko Vodanović
Keyword(s):  
Hepatic Duct ◽  
Imaging Techniques ◽  
Perihilar Cholangiocarcinoma ◽  
Klatskin Tumor ◽  
Left Hepatic Duct ◽  
Hepatic Hilum ◽  
The Right

Altemeier-Klatskin tumor is a perihilar cholangiocarcinoma that occurs within 2 cm of the confluence of the right and left hepatic duct at the hepatic hilum and accounts for 50–70% of all cholangiocarcinomas cases. Although imaging techniques have come very far today, this entity can still be very challenging to diagnose as there are many lesions that can mimic Klatskin tumor. In this review, we will present the most common Klatskin-mimicking lesions.

scholarly journals Anatomic Variations of the Right Hepatic Duct: Results and Surgical Implications from a Cadaveric Study

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Theodoros Mariolis-Sapsakos ◽  
Vasileios Kalles ◽  
Konstantinos Papatheodorou ◽  
Nikolaos Goutas ◽  
Ioannis Papapanagiotou ◽  
...  
Keyword(s):  
Bile Ducts ◽  
Hepatic Duct ◽  
Anatomical Variations ◽  
Common Hepatic Duct ◽  
Drainage Pattern ◽  
Left Hepatic Duct ◽  
Surgical Interventions ◽  
Drainage Patterns ◽  
The Common ◽  
The Right

Purpose. Thorough understanding of biliary anatomy is required when performing surgical interventions in the hepatobiliary system. This study describes the anatomical variations of right bile ducts in terms of branching and drainage patterns, and determines their frequency. Methods. We studied 73 samples of cadaveric material, focusing on the relationship of the right anterior and posterior segmental branches, the way they form the right hepatic duct, and the main variations of their drainage pattern. Results. The anatomy of the right hepatic duct was typical in 65.75% of samples. Ectopic drainage of the right anterior duct into the common hepatic duct was found in 15.07% and triple confluence in 9.59%. Ectopic drainage of the right posterior duct into the common hepatic duct was discovered in 2.74% and ectopic drainage of the right posterior duct into the left hepatic duct in 4.11%. Ectopic drainage of the right anterior duct into the left hepatic ductal system and ectopic drainage of the right posterior duct into the cystic duct was found in 1.37%. Conclusion. The branching pattern of the right hepatic duct was atypical in 34.25% of cases. Thus, knowledge of the anatomical variations of the extrahepatic bile ducts is important in many surgical cases.

scholarly journals Comparative Anatomical, Ultrasonographical and Radiological studies of the biliary system of Rabbits and Domestic cats in Egypt

2019 ◽  
Author(s):  
R.T. Reem ◽  
M.A. Maher ◽  
H.E. Alaa ◽  
H.A. Farghali
Keyword(s):  
Bile Duct ◽  
Gall Bladder ◽  
Cystic Duct ◽  
Hepatic Duct ◽  
Human Model ◽  
Common Hepatic Duct ◽  
Domestic Cats ◽  
Left Hepatic Duct ◽  
Right Lobe ◽  
The Right

ABSTRACTUnder the prevailing overall Conditions of all veterinarians for the diagnosis of biliary diseases, application of surgical procedures and liver transplantation in Cats as carnivorous pet animal, and Rabbits as herbivorous pet animal and also as a human model in research. The present study was constructed on twelve native breeds of rabbits (Oryctolagus cuniculus) and eighteen adult domestic cats (Felis catus domesticus). We concluded that, in brief; the rabbit gall bladder was relatively small, fixed by several small hepato-cystic ducts to its fossa. The rabbit bile duct was formed commonly by the junction of the left hepatic duct and the cystic duct. The cystic duct was commonly fairly large, received the right hepatic duct that collected the right lobe in its route to enter the duodenum, the bile duct receives the branch of the caudate process of the caudate lobe. The present study revealed other four anatomic variations dealing with the shape and size of the feline native breed’s gall bladder from fundic duplication, bilobed, truncated fundus and distended rounded fundus. Commonly, the bile duct was formed by the triple convergence of the left and the right hepatic ducts with the cystic duct. However, in some exceptional cases a short common hepatic duct was formed. Sonographically, the normal gall bladder in rabbit appeared small, elongated with anechoic lumen bordered by right lobe laterally and quadrate lobe medially and has no visible wall, but in cat varied in conformation, bordered by the right medial lobe laterally and the quadrate lobe medially surrounded by echogenic wall.

scholarly journals The segment IV approach: a useful method for achieving the critical view of safety during laparoscopic cholecystectomy in patients with anomalous bile duct

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shuichi Fujioka ◽  
Keigo Nakashima ◽  
Hiroaki Kitamura ◽  
Yuki Takano ◽  
Takeyuki Misawa ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Hepatic Duct ◽  
Left Hepatic Duct ◽  
Critical View ◽  
Critical View Of Safety ◽  
Right Border ◽  
Imaginary Line ◽  
Branching Point ◽  
The Right

Abstract Background The critical view of safety (CVS) method can be achieved by avoiding vasculo-biliary injury resulting from misidentification during laparoscopic cholecystectomy (LC). Although achieving the CVS has become popular worldwide, there is no established standardized technique to achieve the CVS in patients with an anomalous bile duct (ABD). We recently reported our original approach for securing the CVS using a new landmark, the diagonal line of the segment IV of the liver (D-line). The D-line is an imaginary line that lies on the right border of the hilar plate. The cystic structure can be securely isolated along the D-line without any misidentification, regardless of the existence of an ABD. We named this approach the segment IV approach in LC. Methods In this study, we adopted the segment IV approach in patients with an ABD. Results From October 2015 to June 2020, 209 patients underwent LC using the segment IV approach. Among them, three (1.4%) were preoperatively diagnosed with an ABD. The branching point of the cystic duct was the posterior sectional duct, anterior sectional duct, or left hepatic duct in each patient. The CVS was achieved in all cases without any complications. Conclusion It is a promising technique, especially even for patients with an ABD during LC.

scholarly journals Severe case of post cholecystectomy vasculobiliary injury successfully treated by right hepatectomy with a jump graft to the remaining left hepatic lobe

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Carlo Marino ◽  
Ignacio Obaid ◽  
Gabriela Ochoa ◽  
Nicolás Jarufe ◽  
Jorge A Martínez ◽  
...  
Keyword(s):  
Hepatic Duct ◽  
Open Cholecystectomy ◽  
Severe Case ◽  
Common Hepatic Duct ◽  
Right Hepatectomy ◽  
Left Hepatic Lobe ◽  
Left Hepatic Duct ◽  
Hepatic Lobe ◽  
The Right ◽  
Vasculobiliary Injury

Abstract Vasculobiliary injuries (VBI) caused by cholecystectomies are infrequent but extremely serious. We report a case of a severe VBI successfully treated at our center. A 22-year-old woman underwent an open cholecystectomy as treatment for acute cholecystitis and bile duct stones. She was transferred to our center on postoperative Day 4 because of progressive jaundice and encephalopathy. After a proper investigation, we found an extreme VBI with infarction of the right hepatic lobe associated with complete interruption of the portal vein and proper hepatic artery flows and full section of the common hepatic duct. Right hepatectomy with portal—Rex shunt revascularization of the left hepatic lobe and Roux-en-Y hepaticojejunostomy to the left hepatic duct was done. The patient was discharged on the 60th postoperative day. Discussion: This case shows the successful surgical treatment of a severe cholecystectomy’s VBI, avoiding an emergency liver transplant.

scholarly journals A Bullet Injury to the Liver Complicated by Biliary Broncho Pleural Fistula and IVC Thrombosis: Case Presentation and Review for Management Guidelines

2020 ◽  
pp. 1-4
Author(s):  
Arwa El Rifai ◽  
Arwa El Rifai ◽  
M. Zorkot ◽  
S. Emsieh ◽  
G. Abi Saad
Keyword(s):  
Hepatic Duct ◽  
Left Hepatic Duct ◽  
Case Presentation ◽  
Management Guidelines ◽  
Upper Abdominal ◽  
The Right ◽  
Abdominal Quadrant ◽  
Chest Tube Drain ◽  
Bullet Injury

This is a case report of a 20-year-old male who presented to our hospital after sustaining a gunshot to the left upper abdominal quadrant with an exit right below the right scapula. On investigation, he was found to have a large right sided hemothorax and an extensive laceration in the liver. A right chest tube drain was inserted, initially drained blood and days later started draining bile. Consequently, the patient started coughing up bile and diagnosis of a biliary-broncho-pleural fistula was made. ERCP with sphincterotomy and stenting of a left hepatic duct injury was subsequently performed. The patient also developed an IVC thrombus that was discovered incidentally on follow up imaging and was treated with anticoagulation

scholarly journals Intrahepatic bile duct variation: MR cholangiography and implication in hepatobiliary surgery

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Mona El Hariri ◽  
Mohamed M. Riad
Keyword(s):  
Bile Duct ◽  
Hepatic Duct ◽  
Intrahepatic Bile Duct ◽  
Surgical Techniques ◽  
Transplant Proc ◽  
Hepatobiliary Surgery ◽  
Left Hepatic Duct ◽  
Mr Cholangiography ◽  
Anatomic Variants ◽  
The Right

Abstract Background The aim of this study was to assess the prevalence of biliary anatomical variants using 3-T MR cholangiography (MRC) with its impact in reduction of the complication of hepatobiliary surgical techniques. Results MRC was applied to 120 subjects (24 potential liver donors and 96 volunteers) and the right posterior hepatic duct insertion was documented, and accordingly, the biliary variants were classified based on Huang classification (Huang et al, Transplant Proc 28: 1669–1670, 1996). Biliary anatomic variants were divided based on Huang classification: Huang A1, 65.83% (n = 79); Huang A2, 11.67% (n = 14); Huang A3, 13.3% (n = 16); Huang A4, 7.5% (n = 9); and Huang A5, 1.67% (n = 2). The total frequency for A2, A3, A4, and A5 was 34.17% (n = 41). The distance between RPHD insertion and the junction of right and left hepatic ducts (L) was measured, and Huang A1 cases were then subtyped into S1 subtype (L > 1 cm) and S2 subtype (L ≤ 1 cm). We had 52 subjects with subtype S1 (43.33%) and 27 subjects with subtype S2 (22.5%). Twenty-three subjects had bile duct exploration or intraoperative cholangiograms and showed Huang type A1 in 14 (60.87%), type A2 in 3 (13.05%), and type A3 in 6 (26.08%). Twenty-two (95.65%) had the same classification in MRC and intraoperative while only one case (4.35%) was considered as A2 at MRC but the intraoperative classification was Huang A3, which was attributed to the insertion of the RPHD insertion at the distal end of the left hepatic duct. Conclusion MRC is an accurate tool for biliary tract mapping before hepatobiliary surgery to provide excellent identification of biliary variants which can reduce the incidence of biliary complications.

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