The American Association for the Study of Liver Diseases recognizes large volume paracentesis as draining greater than 5 liters of ascites and states there is no limit in the amount of ascites drained with appropriate replacement of albumin. For many practitioners performing safe large volume paracentesis between 5 and 10 liters or even 20 liters is not an uncommon practice. However, drainage of higher volumes outside common practice may raise concerns of patient intolerance and complication.
View Article and Find Full Text PDFIn the setting of portal hypertension, intractable bleeding from anorectal varices is a rare occurrence. In this review, clinical presentation and management of this dilemma are presented in a case-based fashion. Bleeding may occur in the absence of prior history of cirrhosis or gastroesophageal varices and measurement of hepatic venous pressure gradient and liver biopsy could help to establish the diagnosis.
View Article and Find Full Text PDFThe combination of anatomic and metabolic information provided by positron emission tomography (PET)/computed tomography makes it an important imaging modality to be obtained in conjunction with percutaneous ablation of primary and secondary malignancies of the lungs and liver. Advantages include more accurate preprocedural staging to determine appropriate treatment options, intraprocedural guidance to target difficult-to-see lesions, and postprocedural detection of residual or recurrent disease. Future applications of PET include strategies for intraprocedural guidance with real-time determination of incompletely ablated tumor, and combined PET/magnetic resonance imaging before, during, and after ablation for greater sensitivity to detect disease.
View Article and Find Full Text PDFPurpose: To evaluate and compare the rates of complications on follow-up computed tomography (CT) studies of patients with Celect, Günther Tulip, and Greenfield inferior vena cava (IVC) filters.
Materials And Methods: Retrospective review of CT studies obtained 0-1,987 days after infrarenal placement of an IVC filter identified 255 Celect, 160 Tulip, and 50 Greenfield filters. Follow-up CT studies were independently evaluated by two observers for IVC perforation, contact with adjacent organs, and filter fracture.