Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report new operative approaches to the treatment of hepatic vein occlusion due to malignant tumors in the liver and their results in four patients. Two patients had hepatoma, one had metastatic melanoma, and one had metastatic leiomyosarcoma. All of them had abdominal pain, abdominal distention secondary to ascites, and massive hepatomegaly. The right lobe and medial segment of the left lobe of the liver were involved in three patients, and the involvement was diffuse throughout the liver in one. Hepatic veins were occluded completely in one patient, and two of three veins were occluded in the others. Two patients were treated by hepatic resection and removal of tumor thrombus from the hepatic vein under isolation-perfusion technique. They lived 18 and six months, respectively, without recurrence of Budd-Chiari syndrome. Tumors in the other patients were diffuse and could not be resected. The hepatic artery was ligated and chemotherapy was given postoperatively. Ascites and abdominal pain disappeared completely in one, who survived 17 months. The other patient had significant palliation and lived nine months.
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PMID:Surgical management of hepatic vein occlusion by tumor: Budd-Chiari syndrome. 19 61

A variety of indirect techniques has been claimed to provide evidence of spontaneous reversal of portal blood flow in hepatic cirrhosis but the existence of the phenomenon has been doubted by some who do not accept the validity of the indirect evidence. There are few reports of the demonstration of hepatofugal portal flow by selective hepatic arteriography, which is the only acceptable technique. We report three patients with histologically confirmed cirrhosis in whom hepatofugal portal blood flow was unequivocally demonstrated by arteriography, in whom no surgical portosystemic shunt had been performed and in whom there was no evidence of the Budd-Chiari Syndrome or hepatoma, situations accepted as associated with reversed portal blood flow. Theoretical considerations suggest that shunt surgery for bleeding esophageal varices should not be ruled out on the grounds of hepatofugal portal flow. However, end-to-side portacaval anastomosis and distal splenorenal shunt might predispose to the early redevelopment of esophageal varices when reversed portal flow is present. Side-to-side portacaval and conventional splenorenal shunts might be preferable in having less effect on hepatic parenchyma perfusion than when orthograde portal flow in the case.
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PMID:Hepatofugal portal blood flow in hepatic cirrhosis. 62 19

Transarterial embolization given for hepatoma in a patient with Budd-Chiari syndrome resulted in hepatic infarction and inferior vena cava thrombosis. Transarterial membranotomy and repeated infusion of thrombolytic agents and anticoagulants directly in the thrombus brought about improvement of the circulation surrounding the liver and IVC, and recovery from hepatic failure.
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PMID:Useful interventional thrombolytic and anticoagulant therapy for thrombosis due to embolization (TAE) in Budd-Chiari syndrome. 133 19

Some complications of liver transplantation appear as aspecific clinical and blood test abnormalities; others--e.g., hepatic artery thrombosis in the immediate postoperative period and stenosis of the biliary anastomosis before T-tube removal--require early diagnosis. These considerations justify the need of frequent radiologic examination in both the complicated course and the follow-up. The authors report their experience in 59 adult patients submitted to liver transplantation for irreversible liver disease in advanced stage (49 with cirrhosis, 10 with HCC; 5 with cholestatic hepatopathy; 3 with fulminant hepatitis; 1 with Budd-Chiari syndrome; 1 with metastatic APUDoma). Two hundred and sixty-three radiological examinations were performed (Doppler US, CT, angiography and cholangiography) which showed numerous early and delayed complications: 13 of them were treated with interventional radiology maneuvers (US-or CT-guided percutaneous drainage of fluid collections, biliary drainage, bilioplasty, arterial transcatheter embolization). Our results demonstrate that diagnostic and operative radiology are essential for the success of liver transplantation; integrated imaging is particularly important in the diagnosis of complications, while interventional radiology techniques can be usefully employed in their treatment.
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PMID:[Liver transplantation: role of the radiologic methods in the postoperative period]. 145 22

A total of 508 patients had an non-decompression surgery for esophago-gastric varices in our department, from September 1979 to December 1991. These patients consisted of 387 cases of transthoracic esophageal transection with para-esophagogastric devascularization, 40 cases of transabdominal esophageal transection, and 81 cases of Hassab procedure. The original diseases were cirrhosis in 432 patients, IPH in 35, extrahepatic-portal occlusion in 24, primary biliary cirrhosis in 6, Budd-Chiari syndrome in 4, and others in 7. Operative mortality rate was 5.3%. By thoracic approach, esophageal varices completely disappeared. Postoperative cumulative variceal recurrence and bleeding rates at 10 years were 12% and 7%, although recurrence occurred more often than not in cases with hepatocellular carcinoma (HCC). Cumulative survival rates at 5, 10 years were 69%, 46% in liver cirrhosis without HCC. Present study confirmed that our non-decompression surgery is effective in controlling esophagogastric varices in long term of periods.
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PMID:[Results of non-decompression surgery for esophago-gastric varices--postoperative disappearance, recurrence, rebleeding rate of varices, and cumulative survival rate]. 147 Jan 35

Membranous obstruction of the inferior vena cava (IVC) is a curable cause of a primary type of Budd-Chiari syndrome. Magnetic resonance (MR) imaging and vena cavography were performed on nine patients with membranous obstruction of the IVC. The MR findings were retrospectively analyzed and compared with computed tomographic findings in seven patients. The morphologic features of membranous obstruction of the IVC on spin-echo MR images were a curvilinear soft-tissue membrane (five cases) or an obliterated lumen of a hepatic segment of the IVC (four cases) in transverse or sagittal views. The lumen below the obstruction revealed flow-related signal (seven cases), intraluminal thrombus (one case), and thrombotic occlusion (one case). The hepatic veins were narrow and disoriented without connection to the hepatic segment of the IVC just below the diaphragm. On T2-weighted images, inhomogeneity with high signal intensity was shown more prominently in the hepatic parenchyma in Simson type II or III membranous obstruction. Other findings were hepatosplenomegaly, enlarged caudate lobe, cirrhotic liver, associated hepatoma, and presence of various collaterals.
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PMID:Membranous obstruction of the inferior vena cava with Budd-Chiari syndrome: MR imaging findings. 179 12

The general use of synthetic estrogens like DC pointed out that near many skilled collateral effects, some others that are showing with a decrease of bile excretion (cholestasis), reversible with their administration interruption; with hepatic cells adenoma that are potentially premalignant and can transform into hepatocellular carcinoma; with vascular complications such as (most frequently in carcinomatousis) "hepatic peliosis" and "thrombosis" of suprahepatic veins (Budd-Chiari's syndrome). There is no overall increase in the incidence of gallbladder disease (cholelithiasis and cholecystitis).
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PMID:[Oral contraceptive and hepatic effects]. 210 Nov 66

There is no clinical disorder in partial Budd-Chiari syndrome or in a major hepatic vein ligation in hepatic trauma. When considering these findings, it is significant to investigate hepatic subsegmentectomies in which a major hepatic vein is sacrificed. We performed such hepatic subsegmentectomies in nine cases of hepatocellular carcinoma. With the sacrifice of the right hepatic vein, S7, S8 resection was done in three patients, S7 resection in two patients, S8 resection in one patient, and S5 resection in one patient. With the sacrifice of the middle hepatic vein, S8 resection was done in two patients. These resections were successfully performed with no postoperative problem. Further, there were no significant differences in postoperative liver function tests of the patients from those of a control group of the commonly performed systematic segmentectomy and subsegmentectomy. By performing such resections, resection was made possible in three cases and curative resection was made feasible in six cases.
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PMID:Hepatic subsegmentectomy with segmental hepatic vein sacrifice. 216 32

A case of Budd Chiari syndrome in a 50 years female due to hepatoma is reported, which was worked up ultrasonically. A brief review of literature is also presented.
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PMID:Ultrasonic detection of Budd Chiari syndrome in hepatoma. 216 88

We reviewed the CT findings in 17 patients with angiographically proved Budd-Chiari syndrome to determine the ability of CT to show acute thrombosis of the inferior vena cava (IVC) and hepatic veins. In eight patients with membranes (web or band) in the IVC, no thrombus was detected with CT or angiography. In the other nine patients, thrombi in the IVC and/or hepatic veins were seen as intraluminal filling defects that did not change in appearance on precontrast and postcontrast CT scans. Attenuation values of intraluminal filling defects of the IVC ranged from 38 to 42 H in four patients. High-attenuation intraluminal filling defects (60-70 H) of the IVC (five patients) and hepatic veins (one of five patients) were detected. Of these five patients, four had acute symptoms and one had chronic vague symptoms. The underlying disease was a web or band in the IVC and hepatic veins in three patients, invasive hepatocellular carcinoma in one, and injury to the IVC wall during hepatectomy in one. Inferior venacavography showed occlusion of the hepatic segment of the IVC in all five patients. Additional angiograms obtained by injection of contrast medium after a catheter tip was placed in the occluded hepatic IVC showed numerous filling defects suggestive of thrombi of recent onset, which correlated with the high-attenuation thrombi seen on CT scans in two patients. In the remaining three patients, high-attenuation areas in the IVC and hepatic veins also were considered to represent thrombi of recent onset because the attenuation values later decreased to 33-42 H. Spontaneous reduction in diameter of the thrombosed segment of the IVC was observed in four of the five patients. Knowledge of the CT features of acute thrombosis of the IVC and hepatic veins is useful in the early diagnosis of Budd-Chiari syndrome.
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PMID:Acute thrombosis of the inferior vena cava and hepatic veins in patients with Budd-Chiari syndrome: CT demonstration. 280 48


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