ABSTRACT
We describe the hemodynamic features and anatomic basis of false-negative Doppler sonographic findings compared with angiographic findings in a 42-year-old woman after orthotopic liver transplantation complicated by hepatic artery thrombosis. Complete common hepatic artery thrombosis was demonstrated by Doppler sonography and digital subtraction angiography (DSA) on the first postoperative day. A thrombectomy was performed. DSA on the third day after transplantation again showed occlusion of the left hepatic artery. No perfusion was observed in the left hepatic lobe. Liver function remained normal. Doppler sonography on days 8, 10, and 16 after transplantation demonstrated arterial blood flow in both the right and left lobes of the liver, suggesting patent left and right hepatic arteries. Repeat DSA revealed that the arterial flow in the left lobe depended on large, intrahepatic shunts originating from the right hepatic artery. Apparently, shunts can develop within a few days in a transplanted liver from radiologically undetectable structures into vessel-like channels capable of supplying the entire left hepatic lobe.
Subject(s)
Hepatic Artery/diagnostic imaging , Liver Transplantation/adverse effects , Liver/diagnostic imaging , Thrombosis/etiology , Adult , Angiography , False Negative Reactions , Female , Hemodynamics , Hepatic Artery/pathology , Humans , Liver/blood supply , Postoperative Complications , Thrombosis/diagnostic imaging , Ultrasonography, DopplerABSTRACT
An otherwise healthy 15-year-old girl with a congenital nystagmus was evaluated at our department using visual evoked potential recording and magnetic resonance imaging. She appears to have the unique isolated inborn absence of the optic chiasm, described only once before in two unrelated girls. Unlike these previously described cases, our patient does not seem to display a see-saw nystagmus.
Subject(s)
Eye Abnormalities/diagnosis , Nystagmus, Congenital/diagnosis , Optic Chiasm/abnormalities , Adolescent , Evoked Potentials, Visual , Eye Movements , Female , Humans , Magnetic Resonance Imaging , Nerve Fibers/pathology , Optic Chiasm/pathology , Visual Acuity , Visual Field Tests , Visual FieldsABSTRACT
Nine patients with adult-onset acid maltase deficiency (Pompe's disease) were examined clinically and with computed tomography (CT). The CT scan showed early and severe involvement of the muscles of trunk and thighs, with selective sparing of the tensor fasciae latae, short head of biceps femoris, gracilis, and sartorius muscles. Shoulder and leg muscles were less affected. The disease spread over the years from trunk to extremities. Muscle strength and CT findings were positively correlated.
