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[Pericystic pathology and surgery of hepatic hydatidosis. Studies and personal experiences].

In the general study of the consequences of hydatid cysts on the parenchyma of the organ involved, particular interest was given to the conditions of the pericyst. Thus a genuine pericystic pathology was systematized for most evolved pericysts. The signs vary according to the various conditions, sometimes including simple fibrosis, sometimes calcifications with specific and different appearances, almost always chronic inflammation. Fissuration was rare and, more importantly, exogenous vesiculation, a frequent cause of recurrence, was more often noted. The treatment is chosen on these bases, and determined by the local situation, hepatobiliary complications and the general condition of the patient. The author demonstrates the surgical evolution he followed in relation with the progress made in liver surgery, from plain drainage methods to radical pericystectomy and hepatic resection procedures. The conclusions he has drawn as a Symposium moderator during the World Congress of Hydatology held in Madrid in 1985, which will be summed up in the report, still seem to be perfectly valid.

Calcinosis↗

The pattern of liver diseases in Singapore. An autopsy study.

This study is based on an analysis of 1839 consecutive necropsies. Liver diseases are common in Singapore. Of particular importance are cholelithiasis, cirrhosis and primary carcinoma of the liver. Gallstones are mainly of the pigment variety and a significant proportion are present in the bile ducts. The multiracial composition of the population is reflected in a difference in the pattern of liver diseases among the different ethnic groups. Indians are found to have more alcoholic hepatitis and cirrhosis which are often of the micronodular type, while the Chinese have significantly more macronodular cirrhosis and hepatocellular carcinoma. Clonorchiasis and schistosomiasis are confined to the immigrant Chinese. The pattern of liver diseases is changing. Cholangitis and cholangitic abscesses as a result of cholelithiasis are becoming more common while amoebic abscesses and hepatic ascariasis are definitely on the decline. This is attributable to improved sanitary conditions.

Adenoma, Bile Duct↗

[Hepatocellular carcinoma associated with schistosomiasis japonica; CT and angiographic features].

One-hundred and fourteen cases of hepatocellular carcinoma (HCC) which underwent computed tomography (CT) and angiography at the University Hospital of Yamanashi were reviewed. These included 24 cases of HCC associated with hepatic schistosomiasis japonica. Compared with the other cases, radiological features of HCC with schistosomiasis japonica were clarified. Patients with multinodular HCC were most common (13/24), followed by those with single nodular HCC (7/24), while those with massive or diffuse HCC were few (4/24). In patients with marked CT changes (grade III or IV) of hepatic schistosomiasis japonica, most of HCC nodules were disclosed as a mass with homogenous hypodensity surrounded by "shell-like calcifications". Obstruction of the portal vein or its branches due to tumor thrombus was rarely noted (4/24). These features are presumably attributed to periportal fibrosis which is characteristic of heptic schistosomiasis japonica. Because of these features, it is expected that hepatocellular carcinomas with schistosomiasis japonica can be treated by transcatheter arterial embolization more effectively than those without schistosomiasis japonica.

Aged↗

Cholangiocarcinoma masquerading as liver abscess.

A 60-year-old man from Eastern Thailand was admitted to hospital because of right upper quadrant abdominal pain and fever. Ultrasonographic examination revealed two cavitary lesions in the right lobe of the liver. Needle aspiration obtained 110 ml of anchovy sauce-like pus which showed no bacteria on gram stain and routine culture. Serological test for E. histolytica antibody was negative. Initially, the patient responded well to metronidazole. Two weeks later, the symptoms recurred and sonography revealed one large cavitary lesion with three adjacent locules in the right lobe of the liver. Repeated needle aspiration again showed anchovy sauce-like pus which grew Enterobacter agglomerans. O. viverrini ova were detected in the stool. Laparotomy revealed histologically proven cholangiocarcinoma. This report indicates that O. viverrini infection associated with CCC can masquerade as liver abscess.

Adenocarcinoma↗

[Pathology of the digestive tract in kangaroos. A review based on our own study results].

The present paper describes spontaneous pathological findings including etiological aspects in digestive tracts of kangaroos, which have been detected in 166 necropsies during the last 20 years. Protozoan - infections, herpes virus infections, gastroenteritis of unknown etiology and especially the occurrence of the so called "lumpy-jaw" turned out to be of special importance. These findings are discussed with reference to the literature, completed as well by short literature reviews, sub-divided into the different organs and the variable etiology of the diseases, as by a brief description of digestive tract physiology and anatomy in marsupials.

Animals↗

Hepatic regeneration following partial hepatectomy in mice infected with Schistosoma mansoni.

Signs of hepatic regenerative activity were detected by radioactive thymidine incorporation and cariometry in hepatic parenchymal cells of mice infected with 30 cercariae of Schistosoma mansoni for 10 weeks and then submitted to partial (30%) hepatectomy. The same methods failed to detect regeneration in mice submitted to partial hepatectomy, to S. mansoni infection or to sham operation, as well as in normal control mice. The stimulus required for hepatic regeneration in the mouse apparently needs to be strong, as was the case when the effects of partial hepatectomy were added to those of S. mansoni-induced lesions. These data show that extensive schistosomal lesions do not impede hepatic cell regeneration by the mouse.

Animals↗