scholarly journals Haemoperitoneum Due to Spontaneous Rupture of a Liver Metastasis

2019 ◽  
Author(s):  
Christodoulos Dolapsakis ◽  
Polina Pavli ◽  
Andreas Panagopoulos ◽  
Ekaterini Tavernaraki ◽  
Georgios Varnavas ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Metastasis ◽  
Spontaneous Rupture ◽  
Transarterial Embolization ◽  
Performance Status ◽  
Unknown Origin ◽  
Therapeutic Decisions ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Metastatic Liver

Spontaneous rupture of a liver metastasis is a life-threatening complication of metastatic liver disease. Although metastatic liver lesions are much more common than primary tumours, spontaneous rupture of a liver metastasis is rare. Therapeutic decisions must take into account the extent of metastatic liver disease and the patient’s performance status. Transarterial embolization may be considered in cases of ongoing haemorrhage despite initial conservative measures. We describe a case of haemoperitoneum due to spontaneous rupture of a liver metastasis in a 72-year-old patient with carcinoma of unknown origin who responded well to conservative management.

scholarly journals Spontaneous rupture of the pancreatic pseudocyst into the duodenum with massive upper gastrointestinal bleeding: case report and literature review

2020 ◽  
Vol 7 (11) ◽  
pp. 3792
Author(s):  
Alaa Sedik ◽  
Meriem Touheria ◽  
Ahmed Fathi ◽  
Uzair Ilyas ◽  
Ahmed Wahdan ◽  
...  
Keyword(s):  
Spontaneous Rupture ◽  
Pancreatic Pseudocyst ◽  
Bile Leak ◽  
Recurrent Bleeding ◽  
Upper Gi ◽  
Life Threatening ◽  
Upper Gi Endoscopy ◽  
The Common ◽  
Life Threatening Complication ◽  
Acute And Chronic Pancreatitis

Pancreatic pseudocyst is one of the common complications of both acute and chronic pancreatitis. While most pseudocysts resolve spontaneously with conservative treatment, larger pseudocysts are more likely to cause complications, such as, spontaneous rupture into the gastrointestinal tract and are usually associated with life-threatening bleeding, which is life threatening complication. Endoscopic or surgical drainage may be necessary for uncomplicated persistent large cysts. We present a case of 32 year old Indian male, admitted to our department, who was a known case of alcoholic acute pancreatitis treated conservatively and developed massive upper GI bleeding and shock. CT angiography and upper GI endoscopy failed so he was taken to theatre several time due to bleeding, recurrent bleeding and a major bile leak. Unfortunately, he was expired. Current study highlights this serious rare life-threatening complication.

scholarly journals Inflammation in Primary and Metastatic Liver Tumorigenesis–Under the Influence of Alcohol and High-Fat Diets

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 933 ◽  
Author(s):  
Lauren S. Strathearn ◽  
Afanasii I. Stepanov ◽  
Joan Font-Burgada
Keyword(s):  
Liver Disease ◽  
Liver Metastasis ◽  
Alcohol Intake ◽  
Cancer Type ◽  
High Fat ◽  
High Fat Diets ◽  
Excessive Alcohol ◽  
Fat Diets ◽  
Metastatic Liver ◽  
Excessive Alcohol Intake

The liver plays an outsized role in oncology. Liver tumors are one of the most frequently found tumors in cancer patients and these arise from either primary or metastatic disease. Hepatocellular carcinoma (HCC), the most prevalent form of primary liver cancer and the 6th most common cancer type overall, is expected to become the 3rd leading cause of cancer mortality in the US by the year 2030. The liver is also the most common site of distant metastasis from solid tumors. For instance, colorectal cancer (CRC) metastasizes to the liver in two-thirds of cases, and CRC liver metastasis is the leading cause of mortality in these patients. The interplay between inflammation and cancer is unmistakably evident in the liver. In nearly every case, HCC is diagnosed in chronic liver disease (CLD) and cirrhosis background. The consumption of a Western-style high-fat diet is a major risk factor for the development of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH), both of which are becoming more prevalent in parallel with the obesity epidemic. Excessive alcohol intake also contributes significantly to the CLD burden in the form of alcoholic liver disease (ALD). Inflammation is a key component in the development of all CLDs. Additionally, during the development of liver metastasis, pro-inflammatory signaling is crucial in eliminating invading cancer cells but ironically also helps foster a pro-metastatic environment that supports metastatic seeding and colonization. Here we review how Westernized high-fat diets and excessive alcohol intake can influence inflammation within the liver microenvironment, stimulating both primary and metastatic liver tumorigenesis.

scholarly journals Apixaban Causing Hepatic Cystic Bleeding: A Rare but a Life-Threatening Complication

2021 ◽  
pp. 904-909
Author(s):  
Elona Shehi ◽  
Ked Fortuzi ◽  
Haider Ghazanfar ◽  
Shehriyar Mehershahi ◽  
Bhavna Balar
Keyword(s):  
Liver Disease ◽  
Clinical Manifestations ◽  
Polycystic Liver Disease ◽  
Imaging Studies ◽  
Choledochal Cysts ◽  
Liver Cysts ◽  
Polycystic Liver ◽  
Life Threatening ◽  
Embryologic Development ◽  
Life Threatening Complication

Cystic lesions of the liver are a heterogeneous group of disorders with varied etiology, prevalence, and clinical manifestations. Fibropolycystic liver disease encompasses a spectrum of related liver and biliary tract lesions caused by abnormal embryologic development of the ductal plates. These disorders include congenital hepatic fibrosis, biliary hamartomas, polycystic liver disease (PCLD), choledochal cysts, and Carolis disease. PCLD is arbitrarily defined as a liver that contains >20 cysts. Most liver cysts are incidentally found on imaging studies, and the majority of the patients with liver cysts are asymptomatic. Rarely, complications such as compression, infection, and bleeding within the cyst can occur. Under the effect of the increased pressure, the epithelial lining of the cyst undergoes necrosis and sloughing, causing injury of the fragile blood vessels, leading to intracystic bleeding. The bleeding within or from the cyst can be precipitated by anticoagulation. We present a patient with PCLD who developed intracystic bleeding after he was started on apixaban for the prevention of thromboembolism.

scholarly journals Incidence of Spontaneous Pulmonary AVM Rupture in HHT Patients

2021 ◽  
Vol 10 (20) ◽  
pp. 4714
Author(s):  
Adam Fish ◽  
Katharine Henderson ◽  
Alex Moushey ◽  
Jeffrey Pollak ◽  
Todd Schlachter
Keyword(s):  
Spontaneous Rupture ◽  
Pulmonary Hemorrhage ◽  
Initial Presentation ◽  
Lifetime Prevalence ◽  
True Incidence ◽  
Life Threatening ◽  
Life Threatening Complication

The spontaneous rupture of pulmonary AVMs, resulting in pulmonary hemorrhage and hydrothorax, is a life-threatening complication. While this phenomenon has been previously reported, the true incidence is not yet known. This study retrospectively reviewed records of 801 HHT patients with pulmonary AVMs to identify a single lifetime episode of hemothorax or pulmonary hemorrhage secondary to pulmonary AVM rupture. The lifetime prevalence and incidence of pulmonary AVM rupture in HHT patients was 2.7% and 0.16% respectively. In these patients, AVM rupture represented the initial presentation of HHT in nine (40.9%) cases and was life-threatening in nine (40.9%) cases. All cases occurred in virgin lesions, and subsequent embolization was curative. While a feared complication, pulmonary AVM rupture is rare and is likely effectively prevented by existing embolization techniques and indications.

scholarly journals Primary Management of Large Pancreatic Pseudoaneurysm by Ultrasound-Guided Percutaneous Thrombin Injection after Failure of Transarterial Pseudoaneurysm Embolization

2017 ◽  
Vol 01 (02) ◽  
pp. 130-133
Author(s):  
Pawan Garg ◽  
Pushpinder Khera ◽  
Rengarajan Rajagopal ◽  
Neeraj Mehta ◽  
Swarnava Tarafdar
Keyword(s):  
Transarterial Embolization ◽  
High Morbidity ◽  
Thrombin Injection ◽  
Ultrasound Guided ◽  
First Line ◽  
Risk Of Rupture ◽  
Life Threatening ◽  
Percutaneous Thrombin Injection ◽  
Life Threatening Complication ◽  
Primary Management

AbstractPancreatic pseudoaneurysm is a rare but life-threatening complication secondary to pancreatitis, surgery, trauma, or infection. Early treatment is advocated due to high risk of rupture and bleeding. Surgical treatment has traditionally been the first line but is associated with high morbidity. Transarterial embolization or exclusion is the treatment of choice; however, in cases with failure of endovascular treatment, percutaneous thrombin injection can be used successfully. We present a case of a large pancreatic pseudoaneurysm managed successfully with percutaneous ultrasound-guided thrombin injection after failure of transarterial management.

Liver Metastasis: Update on Thermal and Nonthermal Ablative Therapies

2017 ◽  
Vol 01 (03) ◽  
pp. 195-200
Author(s):  
Diego Lopez ◽  
Ronald Arellano
Keyword(s):  
Liver Disease ◽  
Liver Metastasis ◽  
Metastatic Disease ◽  
Recurrent Disease ◽  
Current Status ◽  
Treatment Regimens ◽  
Ablative Therapies ◽  
Ablative Techniques ◽  
Surgical Treatments ◽  
Metastatic Liver

AbstractThe liver is one of the most common sites of metastatic disease from several primary malignancies. While most treatment regimens incorporate a combination of chemotherapy and surgical treatments, ablative techniques are increasingly being used for the treatment of recurrent disease. This article will provide an update on the current status of thermal and nonthermal therapies to treat metastatic liver disease.

Inadequacy of ultrasonography for monitoring response to treatment of liver metastases.

1993 ◽  
Vol 11 (12) ◽  
pp. 2451-2455 ◽  
Author(s):  
A Giovagnoni ◽  
A Piga ◽  
G Argalia ◽  
G M Giuseppetti ◽  
P Ercolani ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Metastases ◽  
Clinical Course ◽  
Hepatic Metastases ◽  
Response To Treatment ◽  
Close Monitoring ◽  
Focal Lesions ◽  
Therapeutic Decisions ◽  
Metastatic Liver

PURPOSE We prospectively evaluated the clinical efficacy of ultrasonography (US) in monitoring the effect of medical treatment in patients with liver metastases, by comparing serial US assessment with serial magnetic resonance imaging (MRI) evaluation and clinical outcome in a group of 41 patients with solid tumors. PATIENTS AND METHODS Both examinations were performed in patients with metastatic liver disease at the start of a new treatment modality and monthly thereafter for 3 months; close monitoring was prolonged beyond the third month in cases in which there was disagreement between the two techniques and the clinical course was not conclusive. RESULTS Planned follow-up was completed in 37 cases. There was limited concordance between the two examinations: in 21 cases only (56.8%), US and MRI gave concordant information on the evolution of hepatic metastases; in eight cases, both agreed on progression of disease (PD), in 11 cases on stable disease (SD), and in one case each on partial response (PR) and complete response (CR). In the remaining 16 cases (43.2%), there was disagreement between the two examinations. On the basis of subsequent clinical course, this discrepancy was shown to be due to US inadequacy in 13 cases and to MRI inadequacy in one case; in two cases, the clinical course was not conclusive. The most striking limits of US appeared to be twofold: (1) a progressive appearance, with chemotherapy, of a diffusely inhomogeneous structure of the liver, resulting in obscuration of focal lesions (and a subsequent judgement of CR) in cases in which lesions were, on the contrary, detected at MRI and usually confirmed by subsequent clinical course; and (2) false US-determined PD in cases in which lesions proven at baseline MRI were noted at US only after one to two courses of therapy. CONCLUSION We conclude that US, which is known to be inaccurate for screening of liver metastases, is unreliable for the follow-up of metastatic liver disease; despite its wide availability, low cost, and noninvasiveness, critical therapeutic decisions should not be made based on the outcome of this test.

scholarly journals Spontaneous Rupture of the Spleen Associated withLegionellaPneumonia

2010 ◽  
Vol 21 (3) ◽  
pp. e107-e108 ◽  
Author(s):  
Manuel Casanova-Roman ◽  
Javier Casas ◽  
Antonio Sanchez-Porto ◽  
Belen Nacle
Keyword(s):  
Abdominal Pain ◽  
Spontaneous Rupture ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Rupture Of The Spleen

Spontaneous rupture of the spleen associated withLegionellapneumonia is a rare and life-threatening complication; only three cases have been reported to date. The authors describe a case of a 47-year-old man who presented with pneumonia and abdominal pain. He underwent a splenectomy, and was successfully treated with clarithromycin and levofloxacin.

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