1,720,998 research outputs found
Are liver cirrhosis and portal hypertension associated with an increased risk of bleeding during laparoscopy? A retrospective analysis of 1000 consecutive cases.
No full textHepatitis C virus infection:sexual or non-sexual transmission between spouses? A case report and review of the Literature.
No full textThe most efficient route of transmission of hepatitis C virus (HCV) infection is through contaminated blood. Sexual transmission or other close human contact could play a role in sporadic infections. We describe a case of acute hepatitis C progressing to chronic hepatitis over a follow-up of 4 years in a 44 -year-old woman having a long- standing monogamous relationship with an HCV infected partner. The infection followed the accidental exposure to her husband's contaminated blood containing a high viral load. The case reported here is the first characterized by a documented direct percutaneous HCV transmission outside the healthcare setting, and suggests that sexual exposure to HCV should be considered only after an accurate exclusion of other routes of intrafamilial spread of the infection. Such conclusion is based on a thorough and updated review of the literature concerning both sexual and household transmission of HCV
Bile leakage and resultant bile peritonitis during or after diagnostic laparoscopy:an unpredictable event.
No full textBile peritonitis secondary to bile leakage is a rare complication of laparoscopy-guided liver biopsy. We report two cases of bile peritonitis occurring, respectively, during and 6 days after liver biopsy in patients with an initial diagnosis of intrahepatic cholestasis associated with chronic pancreatitis. In both cases, bile leakage was first managed by compression with a palpating probe and, at onset or worsening of symptoms, by suture during laparotomy. However, while the first patient progressed uneventfully during the postoperative period, the second died 13 days after laparotomy. In the latter patient, bile leakage was associated with bleeding from the biopsy site with consequently diminished peritoneal irritation and delayed onset of symptoms. In this patient, pancreatic carcinoma, of which evidence was found at autopsy, may also have contributed to the fatal outcome. In conclusion, bile leakage and secondary peritonitis may also occur in the absence of dilation of the biliary tree and may be fatal, especially if not recognized and treated early
Development of mantle cell lymphoma in a patient with adrenocortical carcinoma and an 18-year survival after complete removal of the primary cancer and resection of local recurrences
No full textThe case of a patient with a non-functional and poorly-differentiated adrenocortical carcinoma,who had an enexpected long-term survival after a right adrenalectomy and sebsequent removal of 2 local recurrences,is reported. However, fifteen years after the complete resection of the primary neoplasm, the patient first developed an autoimmune thrombocytopenic purpura and a later a mantle cell lymphoma located in the mediastinal lymph nodes. This case confirms the possible growth of a second tumour in patients with adrenocortical carcinoma, especially if presenting a long survival after resection of the primary malignancy, and emphasises the need for the close follow-up of these patients
Macro-aspartate aminotransferase and pregnancy: any influence?
No full textMacro-aspartate aminotransferase (AST) is a benign condition characterised by unexplained persistent fluctuations f this macroenzyme complex in serum. However, it is not clear what causes this phenomenon or which factors favour its appearance in the blood. Moreaover, it is not known whether normal pregnancy mayinfluence macro-AST levels or whether this biochemical abnormality is transmitted genetically to the newborn. We descibe the effect of pregnancy on macro-AST activity in a young woman and also discuss the possible transmission of the macro-enzyme phenomenon to her baby
Gastrohepatopleural fistula complicating a gastric diverticulum: A rare event and a difficult diagnosis.
No full textA 68-year-old woman developed a gastrohepatopleural fistula with pleural effusion as a result of a gastric diverticulum complicated by a hepatic abscess. The diagnosis required multiple imaging studies, two gastroscopies, and a barium study of the upper gastrointestinal tract. The patient underwent laparotomy with surgical removal of the fistula, which represente a definite intervention if performed early
Laparoscopy and liver biopsy: further evidence that the two procedures improve the diagnosis of liver cirrhosis. A retrospective study of 1,003 consecutive examinations.
No full textRecurrent dermatofibrosarcoma protuberans sixteen years after radical excision. A case report
No full textWe report the case of a young patient with an apparently benign slowly growing lesion which was excised 15 years after its occurrence. However, the histopathological examination revealed a DFSP which necessitated two more surgical procedures for inadequate surgical margins and a skin graft. Notwithstanding these radical operations, the patient presented a local recurrence 16 years later, suggesting that the insidious behavior of the tumour must be taken into account and that patients with DFSP need a life-long follow-up
Congenital anomalies of the spleen mimiking hematological disorders and solid tumors: a single-center experience of 2650 consecutive diagnostic laparoscopies
No full textCongenital anomalies of the spleen range from splenic lobulation, to accessory spleen to polysplenia. Though most of these anatomical variants have no clinical significance, an accessory spleen may simulate a tumor in the adrenal gland, pancreas, stomach or intestine. Alternatively, a missed accessory spleen may be the site of the relapse of a hematological disorder. We, therefore, assessed retrospectively:( i) the frequency of congenital anomalies of the spleen observed during 2650 consecutive laparoscopies and (2) looked for possible misdiagnoses of the accessory spleen as hematological disorders or solid tumors located in the upper quadrant of the abdomen. Congenital anomalies of the spleen were detected in 55 cases, accounting for 2.07%. Accessory spleens were observed in 44 patients (1.6%) and spleen lobulation inn 11 (0.4%). An accessory spleen was the common of the splenic anomalies. Amoung the 44 patients in whom an accessory spleen was discovered laparoscopically, the recognition of this anomaly prevented a relapse of a hematological disease in one case and avoided a useless exploratory laparotomy in the second, where the radiologist had interpreted this malgormation as a space-occupying lesion. In the third case, the accessory splen was initially misdiagnosed as a solid tumor of the pancreas, but was eventually recognized as a congenital anomanly by a second laparoscopy
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