Hypoxic hepatitis in an extensive aortic disecction: case report / Hepatitis hipóxica en una disección aórtica extensa: reporte de caso

Hypoxic hepatitis is an uncommon cause of hepatic damage characterized by a centrolobular necrosis. Its pathophysiology remains unclear. Aortic dissection is a rare but frequently catastrophic event. It is caused by an aortic intimal tear with propagation of a false channel in the media. Depending on the site and extension, it can cause hypoperfusion of any organ leading to cellular ischemia and necrosis. We are presenting a case of hypoxic hepatitis in a patient with an extensive aortic dissection who present to the emergency department.

La hepatitis hipóxica es una causa poco frecuente de daño hepático caracterizada por una necrosis centrolobular. Su fisiopatología sigue siendo poco clara. La disección aórtica es un evento raro pero con frecuencia catastrófico. Dependiendo del sitio y la extensión, puede causar hipoperfusión de cualquier órgano lo que conduce a una isquemia celular y necrosis. Nosotros presentamos un caso de hepatitis hipóxica en un paciente con disección aórtica extensa que se presenta al servicio de emergencia.

Primary hepatic lymphoma mimicking acute hepatitis

No abstract available.

Cholangitis and cholangio-hepatitis: the role of the magnetic resonance

Acute and chronic cholangitis can be complicated by jaundice and infection or sepsis. Modern imaging techniques are capable of visualizing the entire biliary tree. Magnetic Resonance [MR] is capable of better demonstrating also a possible secondary liver involvement. The whole biliary tree and hepatic parenchyma of a group of 20 patients with clinical signs of acute or chronic cholangitis were studied with MR. MR was able to differentiate cases of simple acute or chronic cholangitis from others complicated by a secondary hepatitis, which can be defined as acute or chronic cholangio-hepatitis. Our MR results confirm the great importance of this technique in the study of the biliary tree and of the hepatic parenchyma, contributing to a precise diagnosis and easy differentiation of simple cholangitis, acute or chronic, from other complicated by a secondary hepatitis

CT Diagnosis of Fitz-Hugh and Curtis Syndrome: Value of the Arterial Phase Scan

OBJECTIVE: We wanted to evaluate the role of the arterial phase (AP) together with the portal venous phase (PP) scans in the diagnosis of Fitz-Hugh-Curtis syndrome (FHCS) with using computed tomography (CT). MATERIALS AND METHODS: Twenty-five patients with FHCS and 25 women presenting with non-specifically diagnosed acute abdominal pain and who underwent biphasic CT examinations were evaluated. The AP scan included the upper abdomen, and the PP scan included the whole abdomen. Two radiologists blindly and retrospectively reviewed the PP scans first and then they reviewed the AP plus PP scans. The diagnostic accuracy of FHCS on each image set was compared for each reader by analyzing the area under the receiver operating characteristic curve (Az). Weighted kappa (wk) statistics were used to measure the interobserver agreement for the presence of CT signs of the pelvic inflammatory disease (PID) on the PP images and FHCS as the diagnosis based on the increased perihepatic enhancement on both sets of images. RESULTS: The individual diagnostic accuracy of FHCS was higher on the biphasic images (Az = 0.905 and 0.942 for reader 1 and 2, respectively) than on the PP images alone (Az = 0.806 and 0.706, respectively). The interobserver agreement for the presence of PID on the PP images was moderate (wk = 0.530). The interobserver agreement for FHCS as the diagnosis was moderate on only the PP images (wk = 0.413), but it was substantial on the biphasic images (wk = 0.719). CONCLUSION: Inclusion of the AP scan is helpful to depict the increased perihepatic enhancement, and it improves the diagnostic accuracy of FHCS on CT.

case of type IIa autoimmune hepatitis in a young female

A case of type IIa autoimmune Hepatitis [AIH] who presented to Sultan Qaboos Hospital in February 1995 is presented. The clinical, biochemical, serological and radiological diagnosis and response to treatment is discussed with emphasis that this type of type autoimmune hepatitis has a very good response to treatment