Recanalization of post-transplant late-onset long segmental portal vein thrombosis with bidirectional transhepatic and transmesenteric approach.

PV complications are the most frequent vascular complications in pediatric LT. We have experienced a case with chronic postoperative PVT that necessitates combined transhepatic and transmesenteric approach and have confirmed mid-term patency. An eight-yr-old boy had successful LDLT with a left lateral segment graft at the age of two months for HBV-related acute liver failure.

Balloon-occluded retrograde transvenous obliteration for a portosystemic shunt after pediatric living-donor liver transplantation.

Portosystemic shunts may cause steal phenomenon after liver transplantation, which can lead to graft loss without proper management. Portal vein stenosis is one of the causes for the occurrence of portosystemic shunts after liver transplantation. Recently, new interventional radiologic techniques have been developed in the field of liver transplantation.

Superior mesenteric venous thrombosis treated by direct aspiration thrombectomy.

A 69-year-old man, with hepatits C virus-related liver cirrhosis and hemophilia B, developed massive ascites and watery diarrhea after endoscopic injection sclerotherapy for esophageal varices. A multi detector row computed tomography revealed a superior mesenteric venous thrombus without bowel infarction. It was assumed that the thrombus was caused by transient congestion of the portal system after retrograde propagation of the sclerosant agent, in a condition where anticoagulation proteins, such as proteins C and S, had decreased.

Stent-graft to treat intrahepatic portosystemic venous shunt causing encephalopathy.

Spontaneous intrahepatic portosystemic venous shunts (IPSVS) are rare, and angiographic intervention to treat IPSVS has been limited. To our knowledge, we present the first case of an IPSVS between the right portal vein and inferior vena cava accompanied by intractable encephalopathy that was successfully obliterated using a stent-graft deployed in the inferior vena cava to disconnect the portal and systemic venous circulation. Our patient, a 58-year-old woman, has shown no evidence of recurrent portosystemic venous shunt or encephalopathy for 30 months.

Potential prognostic benefits of radiotherapy as an initial treatment for patients with unresectable advanced hepatocellular carcinoma with invasion to intrahepatic large vessels.

Objectives: To examine the efficacy and prognostic benefits of radiotherapy (RT) in patients who have unresectable advanced hepatocellular carcinoma (HCC) with invasion to intrahepatic large vessels (IHLVs).

Methods: Sixty-eight patients who had advanced HCC with invasion to IHLVs were studied. Thirty-two consecutive patients initially received 3-dimensional conformal RT for HCC invasion to IHLVs.

Intraperitoneal bleeding due to rupture of the left gastric vein (LGV) in a patient with liver cirrhosis: a case report.

Intraperitoneal bleeding from ruptured ectopic varices is a rare and fatal complication in patients with portal hypertension. Although laparotomy with high mortality is performed, it is difficult to detect correct bleeding site and save the patient. This is probably the first case report of rupture from left gastric vein revealed by transjugular intrahepatic portosystemic shunt (TIPS).

Telangiectatic focal nodular hyperplasia of the liver in the perinatal period: case report.

We report a case of congenital telangiectatic focal nodular hyperplasia, a rare variant form of the disease. The patient was a 2-month-old boy whose parents noticed abdominal distention about 2 weeks after birth, and ultrasonogram revealed a large mass in the liver. He underwent right lobectomy, and gross findings showed an ill-defined mass without any central scar.

New diagnostic imaging of gastointestinal tumors: a preliminary study of three-dimensional tumor structure and volumetry.

Background: The aim of the present report was to present preliminary results of the pre-operative evaluation of three-dimensional tumor structure and volumetry using three-dimensional computed tomography (3-D CT) and three-dimensional endoscopic ultrasonography (3-D EUS).

Materials And Methods: Diagnostic imaging was performed for 2 patients (one with gastric cancer, one with a rectal tumor) using virtual endoscopy, 3-D CT for the patient with gastric cancer and 3-D EUS for the patient with the rectal tumor, for the pre-operative evaluation of tumor structure and volumetry. Computer-generated image analysis of resected tumors was also performed.

Hepatic encephalopathy due to intrahepatic portosystemic venous shunt successfully treated by interventional radiology.

We treated a 66-year-old woman with hepatic encephalopathy secondarily induced by an intrahepatic portosystemic venous shunt (IPSVS). In serial observations, the volume of the liver became smaller and encephalopathy could not be controlled with conservative therapy. We occluded the IPSVS successfully using percutaneous transcatheter embolization with micro coils.

Emergent endovascular stent-graft placement to treat ruptured Stanford type B acute aortic dissection.

Uncomplicated Stanford type B acute aortic dissection, for which medical treatments are effective in most cases, is associated with a better prognosis than Stanford type A dissection. However, ruptured Stanford type B dissection still is associated with high mortality, because of the risks of open surgery and the complications of the disease. We report successful stent-graft placement in two patients with acute type B dissection with rupture, and discuss the advantages of stent-graft placement to treat ruptured acute type B dissection.

[Dose investigation of superparamagnetic iron oxide (SPIO) SH U 555 A in liver MR imaging].

SH U 555 A, a new superparamagnetic iron oxide (SPIO) contrast agent for liver MR imaging, was investigated in terms of safety and efficacy. Eighty-four patients with suspected malignant liver tumor were randomly allocated to two groups: the L dose group (8 mumol Fe/kg) and H dose group (12 mumol Fe/kg). Efficacy was qualitatively evaluated through blinded reading of the MR images.

Restoration of thrombopoietin production after partial splenic embolization leads to resolution of thrombocytopenia in liver cirrhosis.

The aim of this study was to evaluate the relation between thrombopoietin (TPO) and thrombocytopenia in patients with liver cirrhosis and those with idiopathic portal hypertension (IPH) before and after partial splenic embolization (PSE). We examined changes in platelet counts, liver function, megakaryocyte function, and plasma TPO levels after PSE in 30 patients (20 with liver cirrhosis, and 10 with IPH). Platelet counts in both cirrhosis and IPH increased significantly 2 months after PSE (cirrhosis group, 4.