Self-expandable metal stent placement combining double balloon endoscopy with a percutaneous approach in a Roux-en-Y hepaticojejunostomy.

The use of the double balloon endoscope for ERCP in patients with surgically altered anatomy has shown to be safe and feasible. This technique permits a variety of diagnostic and therapeutic possibilities. A case is presented of a 38-year old male, admitted with jaundice, 8 months after surgery for a malignant liver tumour with construction of a Roux-en-Y hepaticojejunostomy.

Quantitative multivoxel 1H MR spectroscopy of the brain in children with acute liver failure.

Acute liver failure (ALF)-related encephalopathy was previously characterized by MR spectroscopy of single voxels containing both grey and white matter brain tissue. Quantitative multivoxel MRS was used here to compare grey and white matter brain tissue concentrations of glutamate/glutamine (Glx) and lactate in ALF and associate the results with other liver function parameters. Five pediatric patients with ALF-related encephalopathy and five controls, examined after successful liver transplantation, were examined by brain MRI/MRS.