Hepatic abscesses after liver transplantation secondary to traumatic intrahepatic bile duct injuries in a cadaveric allograft donor.

We report the case of an ultimately successful liver transplant recipient whose post-transplant course was complicated by the early development of multiple abscesses in the graft. Post-transplant cholangiography identified multiple shear injuries to the second and third order intrahepatic bile ducts, originating from blunt trauma to the donor liver. Treatment was non-operative following recent reports of the successful management of intrahepatic bile duct injury in the stable trauma patient. This discussion adds to the limited literature available on the transplantation of injured donor livers, despite this being a relatively common practice. Further experience is needed in determining the appropriate criteria for the use of traumatized donor livers. Cholangiography carried out on the back table may help to determine if such injured livers are suitable for transplantation.

Archeological evidence of parasitic infection from the 19th century company town of Fayette, Michigan.

Archeological deposits from the 19th century company town of Fayette, Michigan were analyzed for evidence of endoparasitic infection in the human population residing in the town between 1867 and 1891. Three privies were associated with upper-income and middle-income neighborhoods; 2 household refuse disposal areas were found in a predominately lower-income immigrant working class neighborhood. Sediment samples from 2 privies associated with dwellings in the middle-income neighborhood were positive for eggs of the human whipworm Trichuris trichiura. The parasite was probably also present among residents of the lower income neighborhood, but the shallow nature of the refuse deposits in that locality precluded preservation of the eggs. Contemporary epidemiologic studies of helminth infections support the belief that T. trichiura may have been a common parasite of 19th century school-age children given the natural inclination of young children to defecate indiscriminately, play freely in the dirt, and eat without washing their hands.