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1.
Rev. medica electron ; 43(2): 3074-3090, mar.-abr. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1251927

ABSTRACT

RESUMEN Introducción: la cirrosis hepática de etiología viral representa un impactante problema de salud a nivel mundial, no solo por su elevada tasa de prevalencia, sino por los costos generados en la atención médica. Objetivos: determinar el comportamiento de los pacientes cirróticos, de etiología viral, en la provincia de Matanzas. Materiales y métodos: se realizó un estudio descriptivo-retrospectivo en 47 pacientes con cirrosis hepática de etiología viral, atendidos en el Servicio de Gastroenterología del Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, de Matanzas, de enero de 2016 a enero de 2018. Los resultados de las variables analizadas se expusieron en tablas de doble entrada. Resultados: el 68,1 % de los pacientes correspondió a cirrosis por virus C. Predominaron los mayores de 50 años, con carga viral entre 4-6,9 log10, y atendidos en régimen ambulatorio. En el 57,4 % se detectaron signos endoscópicos de hipertensión portal, que se corroboraron en el doppler hepático. La ascitis asociada a diferentes sepsis fueron las complicaciones más registradas. El 55,4 % fue clasificado como Child-Pugh A, y el 76,6 % en etapa clínica compensada. Conclusiones: el diagnóstico y seguimiento de la cirrosis hepática viral sigue siendo un verdadero reto para la comunidad médica. De ahí los esfuerzos que han de realizarse para su control desde las fases compensadas, para retardar la aparición de complicaciones (AU).


ABSTRACT Introduction: viral etiology liver cirrhosis is an impacting health problem around the world, not only because of its high prevalence rate but also because of the costs generated by its medical care. Objective: to determine the behavior of the patients with viral etiology liver cirrhosis in the province of Matanzas. Materials and methods: a descriptive-retrospective study was carried out in 47 patients with viral etiology liver cirrhosis treated in the service of Gastroenterology of the Hospital "Comandante Faustino Perez" of Matanzas, from January 2016 to January 2018. The results of the analyzed variables were shown in double-entry tables. Results: 68.1% of the patients presented cirrhosis caused by C virus, Patients elder 50 years old predominated, with 4-6.9 log10, treated in ambulatory regimen. Endoscopic signs of portal hypertension were found in 57.4%. It was corroborated with liver Doppler. Ascites associated to different sepsis were the most frequently registered complications. 55.4% were classified as Child-Pugh A, and 76.6% were in compensated clinical stage. Conclusions: viral liver cirrhosis diagnosis and follow-up is still a true challenge for the medical community, and hence the efforts that should be made to control it from the compensated stages to delay the appearance of complications (AU).


Subject(s)
Humans , Male , Female , Virus Diseases/etiology , Liver Cirrhosis/etiology , Global Health/standards , Chronic Disease/epidemiology , Liver Cirrhosis/diagnosis , Liver Cirrhosis/epidemiology , Liver Diseases/complications , Liver Diseases/diagnosis
2.
Rev. chil. pediatr ; 91(4): 623-630, ago. 2020.
Article in Spanish | LILACS | ID: biblio-1138681

ABSTRACT

Resumen: SARS-CoV-2 es un virus de alta estabilidad ambiental. Es principalmente un patógeno respiratorio que también afecta el tracto gastrointestinal. El receptor ACE2 es el principal receptor de SARS- CoV-2, hay evidencia de su elevada presencia en intestino, colon y colangiocitos; igualmente se en cuentra expresado en hepatocitos pero en menor proporción. SARS-CoV-2 tiene un tropismo gas trointestinal que explica los síntomas digestivos y la diseminación viral en deposiciones. Las caracte rísticas de SARS-CoV-2 incluyen a la proteína S (Spike o Espícula) que se une de forma muy estable al receptor ACE2. La infección por SARS-CoV-2 produce disbiosis y alteraciones en el eje pulmón- intestino. A nivel intestinal y hepático produce una respuesta Linfocitos T evidente y una respuesta de citocinas que producirían daño intestinal inflamatorio. Las manifestaciones a nivel intestinal en orden de frecuencia son pérdida de apetito, diarrea, náuseas, vómitos y dolor abdominal. Éste último podría ser un marcador de gravedad. En niños la diarrea es habitualmente leve y autolimitada. A nivel hepático la hipertransaminasemia ocurre en 40-60% de los pacientes graves. SARS-CoV-2 puede per manecer en deposiciones un tiempo más prolongado que en secreciones respiratorias, este hallazgo influiría en la diseminación de enfermedad. En esta revisión se destaca la importancia de efectuar un reconocimiento precoz de las manifestaciones gastrointestinales y hepáticas, aumentar el índice de sospecha, efectuar un diagnóstico oportuno y reconocer eventuales complicaciones de la enferme dad. La potencial transmisión fecal oral puede influir en la diseminación de enfermedad. Reconocer este hallazgo es importante para definir aislamiento.


Abstract: SARS-CoV-2 is a high environmental stable virus. It is predominantly a respiratory pathogen that also affects the gastrointestinal tract. The ACE 2 receptor is the main receptor of SARS-CoV-2, with evidence of its high presence in the intestine, colon and cholangiocytes, and, in smaller proportion, in hepatocytes. SARS-CoV-2 has a gastrointestinal tropism that explains digestive symptoms and viral spread in stools. The characteristics of this virus include the S (Spike) protein that binds very stably to the ACE-2 receptor and, at the same time, SARS-CoV-2 produces dysbiosis and alterations in the gut-lung axis. It produces a clear T-cell response and a cytokines storm in the intestine and liver that would produce inflammatory bowel damage. Intestinal manifestations by order of frequency are loss of appetite, diarrhea, nausea and vomiting, and abdominal pain, where the latter could be a severity marker. In children, diarrhea is the most frequent symptom, usually mild and self-limiting. In the liver, hypertransaminasemia occurs in severe patients ranging from 40 to 60%. SARS-CoV-2 can re main in stools longer than in respiratory secretions, which would influence the spread of disease. This article highlights the importance of an early diagnosis of gastrointestinal and hepatic manifestations, increase the index of suspicion, make a timely diagnosis, and recognize eventual complications of the disease. The potential oral-fecal route of transmission may influence the disease spread. Recognizing this finding is important to define isolation.


Subject(s)
Humans , Child , Pneumonia, Viral/complications , Coronavirus Infections/complications , Gastrointestinal Diseases/virology , Liver Diseases/virology , Pneumonia, Viral/diagnosis , Severity of Illness Index , Cytokines/metabolism , Coronavirus Infections/diagnosis , Peptidyl-Dipeptidase A/metabolism , Clinical Laboratory Techniques , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/physiopathology , Liver Diseases/diagnosis , Liver Diseases/physiopathology
3.
Rev. medica electron ; 42(4): 2020-2031,
Article in Spanish | LILACS, CUMED | ID: biblio-1139292

ABSTRACT

RESUMEN La microbiota se refiere al conjunto de todos los de microorganismos que se localizan de manera normal en distintos sitios de los cuerpos de los seres vivos pluricelulares, tales como el cuerpo humano. Las modificaciones del eje intestino-hígado se ha convertido en la actualidad en un grave problema científico al haberse encontrado en diversas investigaciones, que esta microbiota está relacionada con el daño hepático con independencia de la causa de la lesión hepática. Se realizó una revisión sistemática sobre las implicaciones demamicrobiota intestinal en las enfermedades hepáticas. Se realizó una revisión de artículos científicos publicados entre 2012 y 2018 en diversas bases de datos en línea. Se presenta el conocimiento existente hasta el momento sobre la microbiota intestinal en pacientes portadores de enfermedades hepáticas, con hincapié en las hepatitis C y la cirrosis hepática. La composición de microbiota de intestino estuvo asociada con el perfil inflamatorio y marcadores de fibrosis hepática, las que mejoraron con el tratamiento de antivirales de acción directa aunque las medidas de permeabilidad intestinal e inflamación permanecían inalteradas. Se reporta mejoría de los pacientes portadores de hepatitis viral tipo C, con antivirales de acción directa la cual estuvo asociada con modificaciones de la microbiota intestinal, que se correlacionó con mejoría en la fibrosis e inflamación hepática, los avances en este campo abren nuevas perspectivas en la biomedicina (AU).


SUMMARY Microbiota refers to the whole of microorganisms located in a normal way in different places of the bodies of pluricelular living beings, like the human body. The modifications of the axis intestine-liver have become a serious scientific problem, because in different researches researchers have found that this microbiota is related to hepatic damage depending on the cause of this hepatic lesion. To carry out a systematic review on the implication of intestinal macrobiota in liver diseases. The scientific articles published in the period 2012-2018 in different databases on line were reviewed. A total of 26 bibliographic sources were used, original articles and reviews. The authors present knowledge existent up to the moment on intestinal microbiota in patients who have liver diseases, making emphasis on hepatitis C and hepatic cirrhosis. The composition of the intestine microbiota was associated to an inflammatory and markers of hepatic fibrosis that improved with the treatment of direct action antivirals although the measures of intestinal permeability and inflammation remained inalterably. It is reported an improvement of patients carriers of viral hepatitis type C with the use direct action retrovirals, what was linked to modifications in the intestinal microbiota, and correlated to an improvement of fibrosis and liver inflammation; the advances obtained in this field open new perspectives in biomedicine (AU).


Subject(s)
Humans , Male , Female , Gastrointestinal Microbiome/physiology , Liver Diseases/classification , Antiviral Agents/therapeutic use , Patients , Chronic Disease/classification , Liver Diseases/diagnosis , Liver Diseases/epidemiology
4.
Rev. medica electron ; 42(3): 1815-1825, mayo.-jun. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1127043

ABSTRACT

RESUMEN Introducción: el embarazo supone cambios en la fisiología de la mujer. Estos cambios pueden llevar a la aparición de enfermedades que afectan el hígado como: síndrome de HELLP, colestasis gravídica intrahepática, esteatosis hepática aguda del embarazo, entre otras, que pueden repercutir en el curso de la gestación. Material y métodos: se realizó un estudio observacional, descriptivo, retrospectivo de corte transversal en 52 gestantes que fueron valoradas en gastroenterología por sospecha de hepatopatías durante el embarazo en el año 2018, que constituyeron el universo de estudio, con el objetivo de determinar el comportamiento de las hepatopatías durante la gestación en las embarazadas valoradas por el servicio de Gastroenterología del Hospital Universitario "Comandante Faustino Pérez Hernández" de Matanzas. Se estudiaron las variables: trimestre gestacional, síntomas y signos, resultados analíticos, entidad nosológica, tipo de parto y complicación neonatal. Se elaboró una planilla para la recolección de los datos. Los resultados se analizaron en frecuencias absolutas y porcientos y se expusieron en tablas. Resultados: predominaron las gestantes del tercer trimestre con 61.6 %. El síntoma más frecuente fue el prurito en 33 gestantes (63.6%). La hipertransaminasemia se manifestó en el 100% de las gestantes. La entidad más frecuente fue la hepatitis crónica por virus B en 19 gestantes (36.5%) seguida de la colestasis intrahepática del embarazo con un 25 %. La mayoría de los partos fueron realizados por cesárea (94.2 %). La principal complicación neonatal fue el bajo peso al nacer en 26 (39.4 %). Conclusiones: las hepatopatías propias de la gestación se comportaron con igual frecuencia descrita en la literatura de acuerdo al trimestre que predominó, aunque fue significativa la incidencia de gestantes valoradas con infección por virus de la hepatitis b cuyo diagnóstico se hizo durante el embarazo siendo la principal causa de las complicaciones neonatales observadas (AU).


SUMMARY Introduction: Pregnancy supposes changes in the woman's physiology. These changes can lead to the appearance of illnesses affecting the liver, such as Hellp syndrome, intrahepatic cholestasis gravidarum, acute hepatic steatosis of pregnancy, among others, that can rebound in the course of the gestation. Materials and methods: a cross-sectional retrospective, descriptive, observational study was carried out in 52 pregnant women that were valued in Gastroenterology due to the suspicion of liver diseases during pregnancy in 2018; they were the universe of the study and the aim was determining the behavior of liver diseases during pregnancy in pregnant women valued in the service of Gastroenterology of the university hospital "Comandante Faustino Pérez Hernández" of the province of Matanzas: The studied variables were: gestational trimester, symptoms and signs, analytical results; nosological entity, type of delivery and neonatal complications. A form was draw up to collect data. The results were analyzed in absolute frequencies and percentages and showed in tables. Results: The third semester pregnant women predominated with 61.7 %. Pruritus was the most frequent symptom in 33 pregnant women (63.6 %). High levels of serum transaminases were present in 100 % of the studied women. The most frequent disease was chronic hepatitis caused by virus B in 19 pregnant women (36.5 %), followed by intrahepatic cholestasis of pregnancy with 25 %. Most of deliveries were performed by cesarean (94.2 %). The main neonatal complication was low weight at birth in 26 (39.4 %). Conclusions: liver diseases that are proper of gestation behaved in the same frequency as they are described in literature in relation to the predominating semester, although it was significant the incidence of assessed pregnant women with infection caused by the virus of hepatitis B diagnosed during pregnancy; it was the main cause of the observed neonatal complications (AU).


Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications , Gastroenterology , Liver Diseases/epidemiology , Maternal Mortality , Epidemiology, Descriptive , Retrospective Studies , Morbidity , Fetal Mortality , Observational Study , Liver Diseases/complications , Liver Diseases/diagnosis , Liver Diseases/etiology
5.
Autops. Case Rep ; 9(2): e2018081, Abr.-Jun. 2019. ilus, tab
Article in English | LILACS | ID: biblio-994658

ABSTRACT

Infantile systemic juvenile xanthogranuloma (ISJXG) is an uncommon form of juvenile xanthogranuloma, a non-Langerhans cell proliferation of infancy and early childhood. In a small percentage of patients, the visceral involvement­most commonly to the central nervous system, liver, spleen, or lungs­may be associated with severe morbidity, and eventually fatal outcome. Here we describe the clinical and pathological findings of a 28-day-old girl with ISJXG who died with respiratory distress syndrome. She had few cutaneous lesions but massive liver and spleen infiltration; other affected organs were multiple lymph nodes, thoracic parasympathetic nodule, pleura, pancreas, and kidneys. Additional findings were mild pulmonary hypoplasia and bacteremia. Immunohistochemistry on fixed tissues is the standard for diagnosis. Immunophenotype cells express CD14, CD68, CD163, Factor XIIIa, Stabilin-1, and fascin; S100 was positive in less than 20% of the cases; CD1a and langerin were negative. No consistent cytogenetic or molecular genetic defect has been identified. This case demonstrates that the autopsy is a handy tool, because hepatic infiltration, which was not considered clinically, determined a restrictive respiratory impairment. In our opinion, this was the direct cause of death.


Subject(s)
Humans , Female , Infant, Newborn , Xanthogranuloma, Juvenile/complications , Liver Diseases/diagnosis , Respiratory Distress Syndrome, Newborn , Autopsy , Xanthogranuloma, Juvenile/congenital , Xanthogranuloma, Juvenile/pathology , Fatal Outcome
7.
Rev. chil. obstet. ginecol. (En línea) ; 84(4): 314-319, 2019. tab
Article in Spanish | LILACS | ID: biblio-1058153

ABSTRACT

RESUMEN La rotura hepática es una complicación poco frecuente de la gestación que se asocia a preeclampsia y síndrome HELLP, aumentando la morbimortalidad materna. No hay reportados casos de esta patología en gestantes residentes en altura, a pesar de que se considera a la altura como un factor que influye en la gestación. En este artículo se reporta el caso de una gestante residente de la gran altura, la cual evidenció una rotura hepática con sangrado persistente, siendo reintervenida por cirugía de emergencia oportunamente gracias al monitoreo hemodinámico con doppler transesofágico.


ABSTRACT Hepatic rupture is a rare complication of pregnancy associated with preeclampsia and HELLP syndrome, thus increasing maternal morbidity and mortality. There are no reported cases of this condition in high-altitude dweller pregnant women, even though altitude is considered a factor that influences in pregnancy. In this article the case of a pregnant dweller at high altitude is reported, which revealed hepatic rupture with persistent bleeding, being reoperated by Emergency Surgery appropriately thanks to the hemodynamic monitoring with transesophageal Doppler


Subject(s)
Humans , Female , Pregnancy , Adult , Pre-Eclampsia/diagnosis , Pregnancy Complications/diagnosis , Rupture, Spontaneous/surgery , Pregnancy Complications/therapy , Ultrasonography, Doppler , Hemodynamic Monitoring , Liver Diseases/diagnosis
8.
Rev. chil. pediatr ; 88(1): 169-175, 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-844593

ABSTRACT

Las fosfatasas alcalinas (FA) son un grupo de 4 isoenzimas que se producen en diversos tejidos, pudiendo elevarse en condiciones fisiológicas y secundariamente a enfermedades óseas o hepatobiliares. En niños una de las causas más frecuentes e inocuas, pero poco conocidas, es la hiperfosfatasemia transitoria benigna de la infancia (HFTBI). El objetivo es reportar una serie de casos de HFTBI y proponer un criterio de enfrentamiento. Casos clínicos: Se presentan 5 niños de entre 11 y 50 meses de edad, 4 de ellos de sexo femenino, con hallazgo incidental de elevación severa (> 1.000 UI/l) en los niveles de FA en exámenes solicitados por mal incremento pondo-estatural o por cuadros infecciosos. A través de la anamnesis, examen físico y laboratorio básico se descartó enfermedad ósea o hepática. En 2 de los pacientes se determinaron las isoenzimas, destacando el predominio óseo. Se comprobó una normalización de los niveles de FA en un periodo de uno a 6 meses, sin evidencia de complicaciones posteriores. Conclusión: La HFTBI es un desorden bioquímico benigno de evolución autolimitada, que es importante tener presente al enfrentar un niño menor de 5 años con elevación severa de FA, en ausencia de alteraciones clínicas o de laboratorio que sugieran enfermedad ósea o hepática.


Alkaline Phosphatase (ALP) is a group of 4 isoenzymes produced in different tissues. Elevated levels of ALP can be developed under physiological conditions, and can indicate the presence of bone or hepatobiliary diseases. In children, one of its most common harmless causes is benign transient hyperphosphatasaemia (BTH), a little known condition. The objective is to report BTH cases and propose a monitoring plan. Case reports: The cases of 5 children aged between 11 and 50 months are presented, 4 of them female, with the incidental finding of a sudden and severe ALP elevation (> 1,000 U/l), in tests ordered due to either abnormal growth and development, or intercurrent infections. Bone and liver disease were ruled out using the patient history, physical examination and basic laboratory results. Isoenzymes levels were determined in 2 patients. A return to normal ALP levels was observed over a period of 1-6 months, with no evidence of further complications. Conclusion: BTH is a benign self-limiting biochemical disorder, which should be considered in children under 5 years old with severe ALP elevation in the absence of clinical or laboratory abnormalities suggestive of bone or liver disease.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Bone Diseases/diagnosis , Alkaline Phosphatase/blood , Liver Diseases/diagnosis , Time Factors , Bone Diseases/enzymology , Retrospective Studies , Isoenzymes/blood , Liver Diseases/enzymology
9.
Rev. méd. Chile ; 144(8): 1078-1082, ago. 2016. ilus, tab
Article in Spanish | LILACS | ID: biblio-830612

ABSTRACT

We report an asymptomatic 23-year-old woman with an isolated and persistent increase in serum levels of aspartate aminotransferase (AST). An extensive work up including laboratory and image testing revealed no abnormalities thus suggesting the presence of macro-AST. A polyethylene glycol (PEG) precipitation assay was performed and confirmed the presence of macro-AST.


Subject(s)
Humans , Female , Young Adult , Aspartate Aminotransferases/blood , Alanine Transaminase/blood , Autoimmune Diseases/diagnosis , Autoimmune Diseases/enzymology , Liver Diseases/diagnosis , Liver Diseases/enzymology
10.
Arq. bras. med. vet. zootec ; 68(3): 629-635, tab
Article in Portuguese | LILACS, VETINDEX | ID: lil-785700

ABSTRACT

Este estudo avaliou a capacidade de um sal mineral rico em molibdênio (Mo) em prevenir a intoxicação cúprica acumulativa (ICA), mediante a análise das variáveis clínicas e dos teores de cobre (Cu) e Mo hepático. Foram utilizados 25 ovinos cruzados da raça Ile-de-France, aleatoriamente distribuídos igualmente em cinco grupos, em que o grupo 1 recebia dieta contendo 80% de volumoso e 20% de concentrado, os grupos 2 e 3 recebiam 50% de volumoso e 50% de concentrado, e os grupos 4 e 5 recebiam a mesma dieta dos grupos 2 e 3, com a adição diária de 150mg de sulfato de Cu. Os grupos 1, 3 e 5 recebiam sal mineral contendo 300ppm de Mo. Foram realizadas três biópsias hepáticas para determinação de Cu, Mo e Zn. Três ovinos do grupo 4 e um do grupo 5 manifestaram ICA. Não houve diferença na frequência de mortalidade entre os grupos (P=0,56). Os teores de Cu hepático nos ovinos com ICA (2450ppm) foram superiores aos que não intoxicaram (1518ppm). Quanto maior a ingestão de Mo na dieta, menor foi o acúmulo de Cu hepático ao término do experimento (r = -0,72).(AU)


The aim of this project is to evaluate the capacity of a molybdenum-rich mineral salt in the prevention of cumulative cooper poisoning (CCP) in sheep, through clinical and hepatic copper and molybdenum concentrations. Twenty five crossbreed Ile-de-France sheep were randomly distributed equally into five groups. Group 1 received a 80% forage and 20% concentrate diet, groups 2 and 3 received a 50% forage and 50% concentrate diet, and groups 4 and 5 received the same diet as groups 2 and 3 with a daily supplementation of 150 mg of copper sulfate. Groups 1, 3 and 5 received a mineral salt with 300 ppm of molybdenum. Three times during the experiment a liver biopsy was carried out to evaluate the degree of copper accumulation. Three sheep from group 4 and one sheep from group 5 showed a clinical picture of CCP. There was no difference in the frequency of mortality between groups 4 and 5 (P=0.56). The liver copper concentration was higher in sheep with CCP (2450 ppm) compared to sheep that did not present CCP (1518 ppm). The higher the ingestion of molybdenum in the diet the lower the liver copper concentration at the end of the experiment (r=-0.72).(AU)


Subject(s)
Animals , Copper , Molybdenum/administration & dosage , Poisoning/veterinary , Sheep , Liver Diseases/diagnosis , Liver Diseases/veterinary , Zinc
11.
Femina ; 43(5): 225-234, set.-out. 2015. tab
Article in Portuguese | LILACS | ID: lil-771218

ABSTRACT

A gestação é um período de significativas modificações no organismo materno, que objetivam promover a homeostase do binômio materno-fetal. Sob o ponto de vista hepático, demais das alterações conspícuas à gravidez, deve o obstetra detectar precocemente anomalias envolvendo o fígado, que complicam até 3% das gestações e são responsáveis por elevada mortalidade materna e perinatal. Por outro lado, certas doenças hepáticas têm sua história natural modificada quando ocorrem durante a gestação, demandando cuidados especiais de uma equipe multidisciplinar que envolva o obstetra e o hepatologista. Este artigo revisa as modificações fisiológicas do sistema hepático na gravidez, assim como suas alterações hepáticas mais prevalentes no Brasil. O objetivo é auxiliar e fornecer orientações ao obstetra e guiar o melhor cuidado das pacientes a fim de prevenir e reduzir as complicações hepáticas na gravidez.(AU)


Pregnancy is a period of significant changes in the mother's organism aimed at promoting the mother-fetus homeostasis. From the hepatic standpoint, the obstetrician should detect early the abnormalities attacking the liver, which complicates up to 3% of pregnancies and are responsible for high rates of maternal and perinatal mortality. On the other hand, some liver diseases have their natural evolution changed when they occur during the pregnancy, requiring special care of a multidisciplinary team involving obstetrician and hepatologist specialists. This study presents the physiological changes of the hepatic system during pregnancy, as well as the most prevalent pregnancy hepatic disorders occurring in Brazil. It aims to help the obstetrician and guide the best patient care to prevent and reduce hepatic complications in pregnancy.(AU)


Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications/etiology , Liver/physiopathology , Liver Diseases/complications , Liver Diseases/diagnosis , Pre-Eclampsia/etiology , Pregnancy, Abdominal/physiopathology , Cholestasis, Intrahepatic/complications , Databases, Bibliographic , HELLP Syndrome/etiology , Fatty Liver/complications , Hyperemesis Gravidarum/complications
12.
Clinics ; 70(7): 486-492, 2015. tab, graf
Article in English | LILACS | ID: lil-752391

ABSTRACT

OBJECTIVE: To determine the associations of liver lobe-based magnetic resonance diffusion-weighted imaging findings using multiple b values with the presence and Child-Pugh class of cirrhosis in patients with hepatitis B. METHODS: Seventy-four cirrhotic patients with hepatitis B and 25 healthy volunteers underwent diffusion-weighted imaging using b values of 0, 500, 800 and 1000 sec/mm2. The apparent diffusion coefficients of individual liver lobes for b(0,500), b(0,800) and b(0,1000) were derived from the signal intensity averaged across images obtained using b values of 0 and 500 sec/mm2, 0 and 800 sec/mm2, or 0 and 1000 sec/mm2, respectively, and were statistically analyzed to evaluate cirrhosis. RESULTS: The apparent diffusion coefficients for b(0,500), b(0,800) and b(0,1000) inversely correlated with the Child-Pugh class in the left lateral liver lobe, the left medial liver lobe, the right liver lobe and the caudate lobe (r=-0.35 to -0.60, all p<0.05), except for the apparent diffusion coefficient for b(0,1000) in the left medial liver lobe (r=-0.17, p>0.05). Among these parameters, the apparent diffusion coefficient for b(0,500) in the left lateral liver lobe best differentiated normal from cirrhotic liver, with an area under the receiver operating characteristic curve of 0.989. The apparent diffusion coefficient for b(0,800) in the right liver lobe best distinguished Child-Pugh class A from B-C and A-B from C, with areas under the receiver operating characteristic curve of 0.732 and 0.747, respectively. CONCLUSION: Liver lobe-based apparent diffusion coefficients for b(0,500) and b(0,800) appear to be associated with the presence and Child-Pugh class of liver cirrhosis. .


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Diffusion Magnetic Resonance Imaging , Hepatitis B/diagnosis , Liver Cirrhosis/diagnosis , Case-Control Studies , Hepatitis B/complications , Liver Cirrhosis/complications , Liver Diseases/complications , Liver Diseases/diagnosis , Prospective Studies
13.
Article in English | WPRIM | ID: wpr-64640

ABSTRACT

Primary hepatic actinomycosis is one of the chronic abscess-forming infections of the liver. Accurate diagnosis is frequently delayed due to its indolent course and nonspecific clinical and radiological manifestations. We report a case of a 57-year-old man presenting with asymptomatic multiple hepatic masses on follow-up abdominal computed tomography performed 1 year after stomach cancer surgery. Although a percutaneous liver biopsy procedure was conducted twice in order to obtain confirmative pathology, only a nonspecific organizing abscess with plasma cell infiltration was revealed, without identification of any organism in the tissue cultures. Ultimately, actinomycosis was diagnosed following the detection of sulfur granules on open surgical biopsied tissue. This case suggests that primary hepatic actinomycosis should be considered as one of the possible causes for enigmatic inflammatory lesions of the liver.


Subject(s)
Actinomycosis/diagnosis , Anti-Bacterial Agents/therapeutic use , Biopsy, Needle , Humans , Liver Abscess/complications , Liver Diseases/diagnosis , Male , Middle Aged , Tomography, X-Ray Computed
14.
Korean Journal of Radiology ; : 1038-1046, 2015.
Article in English | WPRIM | ID: wpr-163299

ABSTRACT

OBJECTIVE: To assess the value of applying MultiVane to liver T2-weighted imaging (T2WI) compared with conventional T2WIs with emphasis on detection of focal liver lesions. MATERIALS AND METHODS: Seventy-eight patients (43 men and 35 women) with 86 hepatic lesions and 20 pancreatico-biliary diseases underwent MRI including T2WIs acquired using breath-hold (BH), respiratory-triggered (RT), and MultiVane technique at 3T. Two reviewers evaluated each T2WI with respect to artefacts, organ sharpness, and conspicuity of intrahepatic vessels, hilar duct, and main lesion using five-point scales, and made pairwise comparisons between T2WI sequences for these categories. Diagnostic accuracy (Az) and sensitivity for hepatic lesion detection were evaluated using alternative free-response receiver operating characteristic analysis. RESULTS: MultiVane T2WI was significantly better than BH-T2WI or RT-T2WI for organ sharpness and conspicuity of intrahepatic vessels and main lesion in both separate reviews and pairwise comparisons (p < 0.001). With regard to motion artefacts, MultiVane T2WI or BH-T2WI was better than RT-T2WI (p < 0.001). Conspicuity of hilar duct was better with BH-T2WI than with MultiVane T2WI (p = 0.030) or RT-T2WI (p < 0.001). For detection of 86 hepatic lesions, sensitivity (mean, 97.7%) of MultiVane T2WI was significantly higher than that of BH-T2WI (mean, 89.5%) (p = 0.008) or RT-T2WI (mean, 84.9%) (p = 0.001). CONCLUSION: Applying the MultiVane technique to T2WI of the liver is a promising approach to improving image quality that results in increased detection of focal liver lesions compared with conventional T2WI.


Subject(s)
Adult , Aged , Aged, 80 and over , Artifacts , Biliary Tract Diseases/diagnosis , Female , Humans , Liver Diseases/diagnosis , Liver Neoplasms/diagnosis , Magnetic Resonance Imaging , Male , Middle Aged , Pancreatic Diseases/diagnosis , Retrospective Studies
15.
Article in English | IMSEAR | ID: sea-157659

ABSTRACT

The exact nature i.e. neoplastic vs. benign of USG detected space occupying lesions are confirmed by computed tomography. In this study we do CECT of 45 cases of sonographically detected space occupying lesions in liver. Some of cases which is very confusing in regards either it is benign or malignant, the computed tomography is more sensitive.


Subject(s)
Adolescent , Adult , Aged , Cysts/diagnosis , Cysts/diagnostic imaging , Female , Humans , Liver/pathology , Liver/diagnostic imaging , Liver Diseases/diagnosis , Liver Diseases/diagnostic imaging , Liver Neoplasms/diagnosis , Liver Neoplasms/diagnostic imaging , Male , Middle Aged , Tomography, X-Ray Computed/methods , Young Adult
17.
Gut and Liver ; : 58-63, 2014.
Article in English | WPRIM | ID: wpr-36652

ABSTRACT

BACKGROUND/AIMS: Inflammatory pseudotumor (IPT) of the liver is a rare disease characterized by chronic infiltration of inflammatory cells. However, the clinical characteristics and outcomes of IPT remain uncertain. METHODS: Clinical features, image findings, and outcomes of 55 patients with histologically proven IPT were evaluated. RESULTS: They consisted of 26 men and 19 women with median age of 65 years. Serum carcinoembryonal antigen and carbohydrate antigen 19-9 levels were normal in 42 patients (93.3%). Enhanced CT scans indicated poorly defined peripheral enhancement (82.5%) at the arterial phase and poorly defined hyperattenuating lesions with internal hypoattenuating areas at the equilibrium phase (77.0%). Gadolinium-enhancement MRI revealed poorly defined peripheral rim-like enhancement (77.8%). Ten patients underwent surgical resection and 35 were treated conservatively with or without antibiotics. No recurrence was noted after surgical resection during follow-up (1 to 48 months). In all patients who received conservative treatment, complete resolution or size reduction was noted during follow-up (1 to 192 months). CONCLUSIONS: CT and MRI provide clues to the diagnosis of IPT in patients with liver masses and normal tumor markers. However, due to the lack of pathognomonic findings, the clinician's suspicion and histological diagnosis are necessary to make an accurate diagnosis of IPT.


Subject(s)
Adult , Aged , Aged, 80 and over , Contrast Media , Female , Granuloma, Plasma Cell/diagnosis , Humans , Liver Diseases/diagnosis , Magnetic Resonance Imaging/methods , Male , Middle Aged , Prognosis , Tomography, X-Ray Computed/methods
19.
Article in English | WPRIM | ID: wpr-114857

ABSTRACT

Hepatobiliary fibropolycystic diseases are a unique group of entities involving the liver and biliary tract, which are caused by abnormal embryologic development of the ductal plates at various stages. We experienced strange hepatobiliary fibropolycystic diseases with a complex mass composed of malformed ducts and biliary cysts, which did not belong to, and were different from, previously known malformations. They were unique in imaging and histologic features. We herein report three cases of monosegmental hepatobiliary fibropolycystic disease mimicking a mass.


Subject(s)
Adult , Bile Duct Diseases/diagnosis , Cysts/diagnosis , Diagnostic Imaging/methods , Female , Fibrosis/diagnosis , Gallbladder Diseases/diagnosis , Humans , Liver Cirrhosis/diagnosis , Liver Diseases/diagnosis , Liver Neoplasms/diagnosis , Male
20.
Article in English | IMSEAR | ID: sea-157550

ABSTRACT

The significance of abnormal liver function tests in the absence of diagnostic serology is unclear. The aim of this prospective study is to report liver biopsy findings in a large group of patients with unexplained abnormal liver biochemistry and correlate them with the clinical features to assess the severity of these diseases. Percutaneous liver biopsy is a relatively safe and accurate method of diagnosing liver disease and should be considered in such cases. A total of 65 liver biopsies were studied, of which, 26.15% (n=17) hepatic tumors, 23.08% (n=15) cirrhosis, 20.00% (n=13) fatty liver and 06.15% (n=4) viral hepatitis were seen. Further, 01.54% case (n=1) each of alcoholic hepatitis, benign recurrent intrahepatic cholestasis, extrahepatic biliary atresia, granulomatous hepatitis, neonatal hepatitis, Niemann-Pick disease and secondary biliary cirrhosis were also observed. Liver biopsy was non specific in 9.23% (n=6) and inadequate in 4.62% (n=3) cases .The role of histopathological examination of liver biopsy is highlighted in this paper.


Subject(s)
Adolescent , Adult , Aged , Biopsy , Female , Humans , Liver/chemistry , Liver/diagnosis , Liver/pathology , Liver Diseases/diagnosis , Liver Diseases/pathology , Male , Middle Aged , Young Adult
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