Background: Mechanisms of hepatic injury remain poorly understood. Surgical literature reports some speculative theories that have never been proved. The aim of this study was to examine the behavior of the liver during brutal frontal deceleration.
Methods: Six trunks, removed from human cadavers, underwent free falls at 4, 6, and 8 meters per second (mps). Accelerometers were positioned in the two lobes of the liver, in front of the vertebra L2, and in the retro hepatic inferior vena cava. Relative motions of the lobes of the liver and of the two other anatomic marks were observed. In parallel, numerical simulations of this experiment have been performed using a finite element model.
Results: In the direction of impact, the vertebra L2 had no considerable displacement with the inferior vena cava. There was a noteworthy displacement between the two hepatic lobes. The left hepatic lobe had a large relative displacement with the vertebra L2 and the inferior vena cava. The right hepatic lobe was more stable with the vertebra L2 and the inferior vena cava. Numerical simulation of the same protocol underlined a rotation effect of the liver to the left around the axis of the inferior vena cava.
Conclusions: These results support the surgical data. They highlight a crucial zone and explain how dramatic lacerations between the two lobes of the liver can occur.
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http://dx.doi.org/10.1097/01.ta.0000196871.19566.92 | DOI Listing |
Ann Surg Oncol
January 2025
Department of Hepatobiliary and Digestive Surgery, Pontchaillou University Hospital, Rennes, France.
Background: Hepatocellular carcinoma (HCC) associated with major vasculature tumor extension is considered an advanced stage of disease to which palliative radiotherapy or chemotherapy is proposed. Surgical resection associated with chemotherapy or chemoembolization could be an opportunity to improve overall survival and recurrence-free survival in selected cases in a high-volume hepatobiliary center. Moreover, it has been 25 years since Couinaud described the entity of a posterior liver located behind an axial plane crossing the portal bifurcation.
View Article and Find Full Text PDFJ Formos Med Assoc
January 2025
Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan; Department of Medical Imaging, National Taiwan University Cancer Center, Taipei, Taiwan.
Background And Purpose: Dual-energy computed tomography (DECT) pulmonary angiography can reliably detect cement pulmonary embolisms (CPEs) and parenchymal perfusion defects. This prospective observational study investigated CPEs in asymptomatic patients using DECT.
Methods: We enrolled 42 patients who underwent vertebroplasty or received cement screws for vertebral augmentation, examining them using spinal computed tomography and DECT pulmonary angiography.
Rev Clin Esp (Barc)
January 2025
Servicio de Medicina Interna, Hospital Universitario General de Valencia; Grupo de trabajo de Insuficiencia Cardíaca yFibrilación Auricular de la SEMI (ICYFA), Spain. Electronic address:
This document provides a comprehensive analysis of the use of point-of-care ultrasound in heart failure (HF), offering detailed recommendations on echocardiography, lung ultrasound, and venous ultrasound. These advanced imaging techniques allow for an accurate, detailed, and non-invasive evaluation of heart failure, facilitating rapid and effective clinical decision-making. Echocardiography enables a rapid assessment of cardiac function at the point of care, enhancing traditional physical examination and being essential for the management of heart failure (HF).
View Article and Find Full Text PDFCurr Probl Cardiol
January 2025
International arrhythmia center, Fundacion cardioinfatil - La Cardio, Division of Cardiology, Bogota, Colombia. Electronic address:
Introduction: Electrophysiologic (EP) procedures are typically performed via the femoral venous system, but in some patients, the inferior vena cava (IVC) is unavailable. The hepatic vein has emerged as a viable alternative to femoral access, providing an inferior route that accommodates large sheaths required for better catheter manipulation. Although the percutaneous transhepatic approach has been used successfully in the pediatric population, its use in adults is scarce, with a complication rate of approximately 5%.
View Article and Find Full Text PDFJ Clin Med
January 2025
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow 107031, Russia.
Ultrasonographic assessment of the diameters of various veins and their indices are among the most applied diagnostic tools for evaluating fluid responsiveness in clinical practice. Despite their widespread use, there is no definitive answer on which is preferable. Our study aimed to investigate the diagnostic accuracy of different venous diameters and their indices to assess fluid responsiveness.
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