Abstract
Introduction. Postresectional liver failure (PLF) is a devastating and fatal complication of major hepatic resection, and we do not have a full understanding of the pathogenic mechanisms involved. No reliable treatment other than liver transplantation currently exists for PLF. Case presentation. A 46-year-old Japanese man experienced PLF after an extended right hepatectomy for liver malignancy. Seven months after surgery, the patient's Model for End-Stage Liver Disease (MELD) score had reached 23. Doppler ultrasound study and three-dimensional computed tomography images showed a stenosed left hepatic vein compressed by surrounding hypertrophied hepatic parenchyma. Transluminal balloon angioplasty and stent placement therapy were conducted eight months after surgery. The pressure gradient between the hepatic vein and right atrium decreased from 13 to 3 mmHg after stent placement. Thereafter, the patient recovered. Conclusion. Hepatic venous compression by surrounding hypertrophied hepatic parenchyma might, at least in part, be associated with the occurrence of PLF. Surgeons should bear this possibility in mind when confronted with cases of PLF, as early diagnosis and stent placement improves patients' chances of recovery.
| Original language | English |
|---|---|
| Article number | 163 |
| Journal | Journal of Medical Case Reports |
| Volume | 4 |
| DOIs | |
| Publication status | Published - May 31 2010 |
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All Science Journal Classification (ASJC) codes
- Medicine(all)
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Compressive stenosis of the left hepatic vein as a pathogenesis of postresectional liver failure : A case report. / Ninomiya, Mizuki; Ikeda, Tetsuo.
In: Journal of Medical Case Reports, Vol. 4, 163, 31.05.2010.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Compressive stenosis of the left hepatic vein as a pathogenesis of postresectional liver failure
T2 - A case report
AU - Ninomiya, Mizuki
AU - Ikeda, Tetsuo
PY - 2010/5/31
Y1 - 2010/5/31
N2 - Introduction. Postresectional liver failure (PLF) is a devastating and fatal complication of major hepatic resection, and we do not have a full understanding of the pathogenic mechanisms involved. No reliable treatment other than liver transplantation currently exists for PLF. Case presentation. A 46-year-old Japanese man experienced PLF after an extended right hepatectomy for liver malignancy. Seven months after surgery, the patient's Model for End-Stage Liver Disease (MELD) score had reached 23. Doppler ultrasound study and three-dimensional computed tomography images showed a stenosed left hepatic vein compressed by surrounding hypertrophied hepatic parenchyma. Transluminal balloon angioplasty and stent placement therapy were conducted eight months after surgery. The pressure gradient between the hepatic vein and right atrium decreased from 13 to 3 mmHg after stent placement. Thereafter, the patient recovered. Conclusion. Hepatic venous compression by surrounding hypertrophied hepatic parenchyma might, at least in part, be associated with the occurrence of PLF. Surgeons should bear this possibility in mind when confronted with cases of PLF, as early diagnosis and stent placement improves patients' chances of recovery.
AB - Introduction. Postresectional liver failure (PLF) is a devastating and fatal complication of major hepatic resection, and we do not have a full understanding of the pathogenic mechanisms involved. No reliable treatment other than liver transplantation currently exists for PLF. Case presentation. A 46-year-old Japanese man experienced PLF after an extended right hepatectomy for liver malignancy. Seven months after surgery, the patient's Model for End-Stage Liver Disease (MELD) score had reached 23. Doppler ultrasound study and three-dimensional computed tomography images showed a stenosed left hepatic vein compressed by surrounding hypertrophied hepatic parenchyma. Transluminal balloon angioplasty and stent placement therapy were conducted eight months after surgery. The pressure gradient between the hepatic vein and right atrium decreased from 13 to 3 mmHg after stent placement. Thereafter, the patient recovered. Conclusion. Hepatic venous compression by surrounding hypertrophied hepatic parenchyma might, at least in part, be associated with the occurrence of PLF. Surgeons should bear this possibility in mind when confronted with cases of PLF, as early diagnosis and stent placement improves patients' chances of recovery.
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U2 - 10.1186/1752-1947-4-163
DO - 10.1186/1752-1947-4-163
M3 - Article
C2 - 20509899
AN - SCOPUS:77952676260
VL - 4
JO - Journal of Medical Case Reports
JF - Journal of Medical Case Reports
SN - 1752-1947
M1 - 163
ER -