Rationale: According to previously published studies, major complications arising from a percutaneous liver biopsy are rare and occur in less than 0.1% of cases. This report describes an approach to percutaneous liver biopsy that can help avoid damage to the liver in a living donor liver transplantation (LDLT) setting.
Patient Concerns: Case 1: In the first case a donor percutaneous liver biopsy (PLB) of both lobes of the liver was performed for pre-LDLT evaluation. The ultrasonography (US)-guided epigastric right-angle approach and an automatic one-handed cocking disposable 18G biopsy gun was used to puncture the left liver lobe to determine the presence of fatty liver. A penetrating liver injury occurred, accompanied by massive bloody ascites (about 700 cc) and subcapsular hematoma at the left lateral segment. The bleeding was managed by bi-polar coagulation during the transplant and the following liver donation procedure proceeded smoothly without any subsequent complications. Case 2: In the second case, selective right lobe PLB for clinical assessment after LDLT was performed in the recipient. Hemorrhagic shock occurred following a puncture of the right posterior branch of the right hepatic artery when using the biopsy-gun via the right lateral intercostal approach.
Diagnoses: Extravasation was documented by angiography and emergent transhepatic arterial embolization was performed.
Intervention: Extravasation was documented by angiography and emergent transhepatic arterial embolization with glue:lipiodol (1:4) was performed to stop bleeding.
Outcomes: The recipient survived after medical management.
Lessons: To prevent complications, the right-angle approach of PLB may be changed to an oblique angle using a one-fire biopsy-gun. Use of a manual Menghini's needle should be considered for left lobe liver biopsies. Since US-guided manual Menghini's needle for PLB can be observed with the needle tip inserted in the liver, needle-mediated compromising of the major vessels or biliary tree can be prevented, and it does not penetrate the liver again. A superficial puncture less than 0.5 cm away from the liver surface should be made during right lobe liver biopsy. This approach can help to avoid damage to the hepatic artery.
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http://dx.doi.org/10.1097/MD.0000000000012742 | DOI Listing |
Differentiation
December 2024
Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Henan University, Kaifeng, 475004, China; Henan Provincial Engineering Center for Tumor Molecular Medicine, Kaifeng Key Laboratory of Cell Signal Transduction, Henan University, Kaifeng, 475004, China. Electronic address:
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Division of Hematology Medical Oncology, Dr. Kariadi General Hospital Semarang/Faculty of Medicine Diponegoro University, Semarang, Indonesia.
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Aust Vet J
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Centre for Veterinary Education, The University of Sydney, Sydney, Australia.
In cats, mycobacteriosis tends to present in a syndromic manner, with cases either being due to tuberculosis (TB) (in countries where TB is endemic), one of the "leprosy-like" diseases affecting the skin and subcutis, panniculitis caused by infection of subcutaneous tissues generally with rapidly growing Mycobacteria spp. or widely disseminated granulomatous disease, which is usually caused by members of the Mycobacterium avium-intracellulare complex (MAC). Disseminated MAC disease is rare, but when it occurs, usually develops in immunocompromised hosts with defective cell-mediated immunity.
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The Concern Foundation Laboratories at The Lautenberg Center for Immunology and Cancer Research, Israel-Canada Medical Research Institute, Faculty of Medicine, The Hebrew University, Jerusalem, Israel; Department of Pathology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. Electronic address:
Background And Aims: RORc-expressing immune cells play important roles in inflammation, autoimmune disease and cancer. They are required for lymphoid organogenesis and have been implicated in tertiary lymphoid structure (TLS) formation. TLSs are formed in many cancer types and have been correlated with better prognosis and response to immunotherapy.
View Article and Find Full Text PDFMetabolism
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Department of Pathology, School of Basic Medical Sciences, Wannan Medical College, Wuhu, China; Postdoctoral Research Station of Clinical Medicine, Jinan University, Guangzhou, China. Electronic address:
Background & Aims: Abnormal expression of long noncoding RNAs is strongly linked to metabolic dysfunction-associated steatotic liver disease (MASLD). However, the precise molecular mechanisms remain unclear. This study explores the roles of noncoding RNA activated by DNA damage (NORAD)/miR-511-3p/Rho-associated protein kinase 2 (Rock2) axis and the NORAD/ROCK2 interaction in the development of MASLD.
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