Compressive stenosis of the left hepatic vein as a pathogenesis of postresectional liver failure: A case report

Mizuki Ninomiya, Tetsuo Ikeda

Research output: Contribution to journalArticle

4 Citations (Scopus)

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 languageEnglish
Article number163
JournalJournal of Medical Case Reports
Volume4
DOIs
Publication statusPublished - May 31 2010

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Hepatic Veins
Liver Failure
Pathologic Constriction
Liver
Stents
Doppler Ultrasonography
End Stage Liver Disease
Balloon Angioplasty
Hepatectomy
Heart Atria
Angioplasty
Liver Transplantation
Early Diagnosis
Tomography
Pressure
Therapeutics
Neoplasms

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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 journalArticle

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