[Primary hepatic leiomyoma].
A young woman of 34 years old had an asymptomatic intrahepatic mass. The histological diagnosis, performed after a right lobe hepatectomy, was of leiomyoma of the liver.
Biomedical subjects
Publications and source records attributed to A Thau.
A young woman of 34 years old had an asymptomatic intrahepatic mass. The histological diagnosis, performed after a right lobe hepatectomy, was of leiomyoma of the liver.
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Serum bile acids were determined in 13 cirrhotic patients with portacaval shunt and in 15 with mesocaval shunt. 20 nonshunted cirrhotics were used as controls. Serum bile acid levels were higher in portacaval (26.7 +/- 14.3 micrograms/ml) than in mesocaval shunt patients (16.9 +/- 8.1 micrograms/ml) and controls (14.1 +/- 11.5 micrograms/ml). The cholic/chenodeoxycholic ratio was lower after portacaval shunt than after mesocaval shunt (0.36 +/- 0.15 and 0.63 +/- 0.26, respectively). It is hypothesized that these findings may be consistent with a larger hepatic blood flow present in mesocaval shunted patients and with chenodeoxycholic absorption in the upper small intestine.
Seventy-nine mesocaval shunts using the internal jugular vein and 54 side-to-side portocaval shunts have been performed during the past six years. Patients were evaluated from the stand-point of protection from recurrent bleeding, patency of the shunt, encephalopathy, rehabilitation and long term survival. All of the patients underwent follow-up observation. In a selected group of patients, postoperative angiographic control was performed, and serum levels of octopamine were examined. In the mesentericocaval group, patency of the shunt was demonstrated in 82 per cent, the incidence of encephalopathy was 35 per cent and the long term survival rate, as computed by the actuarial method, was 65 per cent. In the portocaval group, the incidence of encephalopathy was 54 per cent and the survival rate, 38 per cent. There was no correlation between octopamine serum levels and encephalopathy. Persistent perfusion of the liver was documented in 95 per cent of the patents controlled by arteriography in the mesentericocaval group with patent shunts. The mesentericocaval shunt seems to be an effective technique in terms of incidence of encephalopathy and survival rate, but a randomized study will be necessary to prove that this technique is more effective than the standard portocaval shunt.
Data relating to 30 patients subjected to side-to-side porta-cava anastomosis and 30 to mesenterico-cava by-pass with the internal jugular vein are presented. At follow-up after a period of over 1 yr, encephalopathy was observed in 40% and 21% of the two groups respectively. Angiography of the coeliac tripod and superior mesenteric showed the existence of a post-operative hepatopetal flow in 80% of porta-cava cases. This incidence was only 30% in the mesenterico-cava group. The relation between the clinical and angiographic data is briefly discussed and neuropsychiatric findings in patients with a picture of hepatic encephalopathy are also presented.
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Explore the source record for details and available documents.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.