[Unusual complication of peritoneovenous shunt].
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Biomedical subjects
Publications and source records attributed to T Yandza.
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It has been suggested that, in transplantation organs, the lesions observed after conservation then reperfusion could be related to the formation of oxygenated free radicals. The aim of our work was first to verify the hypothesis that oxygenated free radical are formed after ischaemia-reperfusion of the liver, then to evaluate the effects of the allopurinol and glutathion, known antagonists of oxygenated free radicals, contained in the University of Wisconsin conservation fluid. The University of Wisconsin solution was compared with a Collins solution which does not contain oxygenated free radical antagonists. An orthotopic liver transplantation model was used in Wistar rats. Three groups were studied. In the control group, 5 rats underwent laparotomy then were closed with no surgery being performed. In the Wisconsin group (n = 6) and the Collins group (n = 6) the livers were washed and conserved in the corresponding solution at 4 degrees C before transplanting. Plasma levels of malonyldialdehyde, measured by high performance liquid chromatography, were used as a marker for the formation of oxygenated free radicals. Impaired liver function was assessed on the basis of mortality and serum transaminases, alkaline phosphatase and total bilirubin levels. Liver biopsy was performed at sacrifice. The level of malonyldialdehyde was significantly higher in the transplanted groups compared with the control group (p < 0.01). There was no difference between the Wisconsin and the Collins groups. Hepatic function was significantly reduced in the transplanted groups compared with the control group (p < 0.05). There was no significant difference between the Wisconsin and the Collins groups.(ABSTRACT TRUNCATED AT 250 WORDS)
BACKGROUND: Kasabach-Merritt syndrome is characterized by one or more large hemangiomas associated with thrombocytopenia due to platelet trapping. The hemangiomas may be located in the abdominal viscera, in which case, treatment may be difficult. CASE REPORT: A 2 1/2 month-old boy was admitted because of the discovery of an abdominal mass. He was anemic (hemoglobin: 6.8 g%; reticulocytosis: 288,000/mm3), thrombocytopenic (50,000/mm3), hypofibrinogenemic (0.95 g/l), with fibrin split products in the blood. Ultrasonography showed that this mass was retroperitoneal and heterogeneous. X-rays delineated the mass, which distorted the duodenal loop and pressed forward against the stomach. Surgery showed that the mass included the pancreas, the root of mesenterium and the extrahepatic bile duct. This mass was biopsied. Histological examination showed infantile type hemangioendothelioma. Abdominal angiography showed that the mass was not very hypervascularized, and there were no dilated supplying blood vessels. An aortogram showed two other small vascularized areas. The patient was given methylprednisolone, but the volume of the mass remained unchanged, while hepatosplenomegaly and jaundice developed and ultrasound showed dilated extra- and intrahepatic biliary ducts. The patient was then given interferon alpha 2b for 1 month. Embolization of the small supplying arteries was performed because of a lack of improvement after 1 week of treatment. This procedure was followed by rapid disappearance of the signs of consumption coagulopathy, a progressive improvement in cholestasis, and decrease in the mass. CONCLUSION: Improvement in manifestations of this Kasabach-Merritt syndrome is difficult to assign to one of the several therapies. The rapid disappearance of consumption coagulopathy after arterial embolization suggests that this treatment was successful in our patient.