ABSTRACT
We report the first case of hepatocellular injury occurring in a patient treated for metastatic gastrointestinal stromal tumour (GIST) with imatinib mesylate, with two positive rechallenges including one with 2.5% of the current therapeutic dosage. The patient could be treated later with sunitinib without liver toxicity. Grade 3-4 liver toxicity could occur in one out of 40 treated patients with imatinib for GIST, and fatalities have been reported. Regular monitoring of liver function tests is essential in patients treated with imatinib.
Subject(s)
Antineoplastic Agents/adverse effects , Chemical and Drug Induced Liver Injury/etiology , Gastrointestinal Stromal Tumors/drug therapy , Piperazines/adverse effects , Protein Kinase Inhibitors/adverse effects , Pyrimidines/adverse effects , Aged , Benzamides , Chemical and Drug Induced Liver Injury/pathology , Female , Humans , Imatinib Mesylate , Middle AgedABSTRACT
The authors report the case of a 14-year-old boy with complete isthmic rupture of a horseshoe kidney after a bicycle accident. The imaging diagnosis was difficult because of the presence of a massive retroperitoneal haematoma. However, sonography and CT should be sufficient to detect associated signs, such as malrotation of the renal hila and low-lying kidneys. Laparotomy was indicated because of the unstable haemodynamic state, allowing haemostasis and suture of the two isthmic sections.
Subject(s)
Kidney Diseases/complications , Kidney/abnormalities , Adolescent , Humans , Kidney Diseases/diagnosis , Kidney Diseases/surgery , Male , Rupture, SpontaneousABSTRACT
INTRODUCTION: Bile leak is a rare - and difficult to diagnose - complication of nonoperative treatment in blunt liver injury. Magnetic resonance cholangiopancreatography (MRCP) enables a positive diagnosis and localization of the biliary peritoneal fistula. CASE: We report the case of a child with blunt liver injury treated nonsurgically and subsequently complicated by bile leak. Percutaneous drainage was performed after localization of the biliary fistula with MRCP. The patient recovered without adverse sequelae. CONCLUSION: MRCP can be successfully used to diagnose abdominal complications of blunt liver injury. This minimally invasive approach is the gold standard for management of 80% of patients with blunt liver injury.
