1.Paying attention to other systemic diseases of hepatic manifestations: a return to common sense in clinical practice.
Chinese Journal of Hepatology 2022;30(4):345-346
Liver have complex functions with a high workload. Various liver diseases are the result of the interaction of diverse genetic and environmental factors. Moreover, other systemic diseases may also affect liver, producing corresponding manifestations, such as abnormal liver function tests, portal vein or hepatic vein thrombosis, portal hypertension, hepatosplenomegaly and liver space-occupying lesions. Therefore, it is extremely important for hepatologists to have an in-depth understanding of other systemic diseases of hepatic manifestations, especially hematologic, connective tissue, endocrine, and circulatory, in order to improve the level of clinical diagnosis and treatment.
Humans
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Hypertension, Portal
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Portal Vein/pathology*
4.Role of Doppler Ultrasonography in Portal Hypertension.
The Korean Journal of Gastroenterology 2006;48(3):215-217
No abstract availble.
Blood Flow Velocity
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Humans
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Hypertension, Portal/*ultrasonography
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Liver Cirrhosis/pathology
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Portal Vein/ultrasonography
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*Ultrasonography, Doppler
5.Hepatic manifestations of hematological diseases.
Shan SHAN ; Xin Yan ZHAO ; Ji Dong JIA
Chinese Journal of Hepatology 2022;30(4):347-351
Liver involvement is often observed in hematological disorders, resulting in liver abnormality, including unconjugated hyperbilirubinemia, monoclonal hyperglobulinemia, portal vein, or hepatic vein thrombosis or portal hypertension, hepatosplenomegaly, or iron accumulation in the liver. Here we summarize the major hematological diseases that often affect the liver: hemolytic anemia, defect in coagulation or anti-coagulation factors, myeloproliferative neoplasm, hemophagocytic lymphohistiocytosis, multiple myeloma, leukemia, and lymphoma. We hope this review will help clinicians diagnose and manage the patients with liver involvement by hematological disorders.
Hematologic Diseases
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Humans
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Hypertension, Portal
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Myeloproliferative Disorders/diagnosis*
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Portal Vein/pathology*
6.Hypoplasia of the Left Portal Vein Territory of the Human Liver: A Case Study.
Yong Hyun CHO ; Gen MURAKAMI ; Moo Sam LEE ; Chang Ho SONG ; Eui Hyeog HAN ; Zhe Wu JIN ; Baik Hwan CHO
Journal of Korean Medical Science 2003;18(6):828-832
Although reports of hypoplasia or absence of the liver of left lobe are not few, descriptions of the intrahepatic vessels are rare but valuable for discussion of the pathogenesis. The present report demonstrates a case of the left surgical lobe hypoplasia that is characterized by 1) the scar-like lobe with few parenchymal tissue and dilated bile ducts, 2) no Spiegel's lobe with the portal vein stuck to the inferior vena cava, 3) unusual configurations of the right hepatic vein and the 8th segmental portal vein branch, 4) the hepatic groove on S8, and 5) the trifurcation pattern of the portal vein primary division. According to the macroscopic and histological observations, we hypothesized that the secondary abnormal peritoneal fusion occurred in utero and/or during the postnatal growth, and that it involved the left portal vein and other adjacent structures, resulting in severe atrophy of the left surgical lobe.
Cadaver
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Female
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Human
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Korea
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Liver/*blood supply/*pathology
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Middle Aged
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Peritoneum/pathology
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Portal Vein/*pathology
7.Diagnostic value of contrast-enhanced ultrasound in hepatic epithelioid hemangioendothelioma.
Ya Dan XU ; Han Tao WANG ; Yu Li ZHU ; Yi DONG ; Wei Bin ZHANG ; Wen Ping WANG ; Feng MAO ; Zheng Biao JI
Chinese Journal of Hepatology 2023;31(6):589-593
Objective: To investigate the features of contrast-enhanced ultrasound (CEUS) in hepatic epithelioid hemangioendothelioma (HEHE) in order to improve the preoperative diagnosis rate. Methods: CEUS images of 32 pathologically-proven cases of hepatic epithelioid hemangioendothelioma from January 2004 to August 2021 were collected. Lesions were analyzed to observe the features of enhancement mode, enhancement intensity, and distinct enhancement phases. Results: Among the 32 cases, one had a solitary lesion, 29 had multiple lesions, and two had diffuse-type lesions. Contrast-enhanced ultrasound revealed a total of 42 lesions in 32 cases. In terms of arterial phase enhancement, 18 lesions had overall enhancement, six lesions had uneven dendritic enhancement, 16 lesions had rim-like enhancement, and two lesions had just slight peripheral spot enhancement around the lesions. Among the three cases, there were multiple lesions that had overall enhancement and ring enhancement. In terms of the enhancement phase, 20 lesions showed "fast progression", 20 lesions showed "same progression", and two lesions showed "slow progression". During the late arterial or early portal venous phases with rapid washout, all lesions manifested as hypoechoic. With peaked enhanced intensity, 11 lesions had a lower enhancement intensity than the surrounding normal liver parenchyma; 11 lesions had the same enhancement degree as the surrounding normal liver parenchyma; and 20 lesions had a higher enhancement degree than the surrounding normal liver parenchyma. All 16 ring-enhancing lesions had marked hyperenhancement. In the typical enhancing lesions, four showed hyperenhancement, five showed low enhancement, and nine showed isoenhancement. In the dendrite-enhancing lesions, there were two isoenhancing and four hypoenhancing. Contrast-enhanced ultrasound delineated the boundaries of all lesions more clearly than two-dimensional ultrasound. Conclusion: Contrast-enhanced ultrasound has certain value in the diagnosis of hepatic epithelioid hemangioendothelioma.
Humans
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Hemangioendothelioma, Epithelioid/pathology*
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Contrast Media
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Retrospective Studies
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Liver Neoplasms/pathology*
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Portal Vein/pathology*
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Ultrasonography
8.Living-related liver transplantation for cavernous transformation of portal vein: a clinical study of 3 cases.
Ming-man ZHANG ; Xian-qing JIN ; Lü-nan YAN ; Quan KANG ; Chun-bao GUO
Chinese Journal of Hepatology 2008;16(4):270-273
OBJECTIVETo review the outcomes of living-related liver transplantation (LRLT) in treating 3 cases of cavernous transformation of portal vein (CTPV) with severe portal hypertension.
METHODSThree children (two boys and one girl) were presented to our hospital with recurring esophageal variceal bleeding, decompensating ascites, splenomegaly and refractory anemia. CTPV was confirmed by intravenous computed tomographic portography using a helical computed tomography scanner and 3-dimensional image reconstruction. LRLT were performed in these 3 patients from July 2006 to January 2007. The evaluation of the outcomes was made by referring to their clinical features and laboratory and imaging examination findings.
RESULTSAlthough one patient died from early graft thrombosis, the other two patients showed excellent prognoses. They lived and stayed well during a follow-up period of 12-14 months. Following the transplantations, there had been no esophageal variceal hemorrhage, the ascites disappeared and the portal hypertension vanished. Their hemoglobin, blood platelets count, and serum albumin reached normal values.
CONCLUSIONLRLT is an effective procedure in treating CTPV with severe portal hypertension. The reconstruction of the portal vein is the difficult part of the LRLT procedure.
Child ; Female ; Humans ; Hypertension, Portal ; pathology ; surgery ; Liver Transplantation ; Living Donors ; Male ; Parents ; Portal Vein ; pathology ; Treatment Outcome
9.Surgical Management of Pancreatic Cancer.
The Korean Journal of Gastroenterology 2008;51(2):89-100
Pancreatic cancer is a major problematic concern among all forms of gastrointestinal malignancies because of its poor prognosis. Although significant progress has been made in the surgical treatment in terms of increased resection rate and decreased treatment-related morbidity and mortality, the true survival rate still remains below 5% today. Surgical options for pancreatic cancer are based on the its unique anatomy and physiology, catastrophic tumor biology, experience of surgeon, and status of patients. Four main options exist for the surgical treatment of pancreatic cancer. These include standard "Whipple" pancreaticoduodenectomy (PD), pylorus preserving PD (PPPD), distal pancreatectomy (left-side pancreatectomy), and total pancreatectomy according to the location of tumor. Portal vein involvement by tumor is regarded as an anatomical extension of disease, and en bloc resection of portal vein with tumor is recommended if technically feasible, which is stated in 2002 AJCC tumor staging for pancreatic cancer. In comparison of the survival rates between standard and extended resection of pancreatic head cancer, no significant survival benefit was demonstrated from the prospective reports. PPPD may be superior to standard PD in respect to nutrition and quality of life without any deleterious effect upon long term survival or tumor recurrence. New surgical treatment modalities including modified extended pancreatectomy, neoadjuvant chemotherapy, and radical antegrade modular distal pancreatectomy have been tried to improve the patients' survival. However, early diagnosis and treatment remain as key factors for the cure of pancreatic cancer irrespective of various surgical trials.
Humans
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Neoplasm Staging
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Pancreatic Neoplasms/mortality/pathology/*surgery
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Pancreaticoduodenectomy
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Portal Vein/pathology/surgery
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Prognosis
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Survival Rate
10.Efficacy evaluation of novel oral anticoagulants in patients with cirrhosis accompanied with portal vein thrombosis: a meta-analysis.
Xiao Tong XU ; Yu Wei LIU ; Jing Lan JIN
Chinese Journal of Hepatology 2023;31(6):614-620
Objective: To analyze the safety and efficacy of using novel oral anticoagulants (rivaroxaban and others) in patients with cirrhosis accompanied with portal vein thrombosis (PVT). Methods: Clinical research literature published from the establishment of the database to June 20, 2021, was retrieved from PubMed, Web of Science, CNKI, Wanfang, and Weipu databases by combining subject terms and free words. RevMan software was used for the random group meta-analysis model. Results: In terms of PVT recanalization, the novel oral anticoagulants (such as low molecular weight heparin and others) had a higher recanalization rate than traditional anticoagulants (OR = 13.75, 95%CI 3.58-52.9, P = 0.000 1). In terms of bleeding, the novel oral anticoagulants did not increase the risk of bleeding compared with traditional anticoagulants (OR = 2.42, 95%CI 0.62-9.41, P = 0.20). Conclusion: The novel oral anticoagulant drugs are superior to traditional anticoagulants in terms of the occurrence of PVT recanalization; however, there is no statistically significant difference in terms of the occurrence of bleeding between the two groups.
Humans
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Portal Vein/pathology*
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Treatment Outcome
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Venous Thrombosis/complications*
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Liver Cirrhosis/pathology*
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Anticoagulants/therapeutic use*
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Hemorrhage