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)

Two cases of intrahepatic porto-capsular vein anastomosis are described, both of which were complicated by liver cirrhosis and hepatocellular carcinoma. In both cases a branch of the portal vein in the posterior segment of the liver was markedly dilated and directly anastomosed at its periphery with the liver's capsular vein, then connected with the inferior vena cava. One of the two cases underwent partial hepatectomy. Histopathological examination of the resected specimen did not reveal any direct relation between the shunt and the carcinoma. The shunting in both cases appeared to have resulted from portal hypertension complicated by liver cirrhosis.
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PMID:Aneurysmal intrahepatic porto-capsular vein anastomosis. 220 34

The authors describe a recent case of agenesis of the right lobe of the liver. Such cases are rare and can be diagnosed with state of the art imaging modalities, ultrasound and computed tomography, which permit early diagnosis and help avoid liver complications of cirrhosis, cholangiocarcinoma and hepatoma. This type of congenital anomaly can be associated with biliary tract disease, portal hypertension or other congenital anomalies.
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PMID:[Agenesis of the right lobe of the liver. Apropos of a case]. 222 79

This study was undertaken to analyse the clinical spectrum of chronic liver disease (cirrhosis, and others with portal hypertension) in Kuala Lumpur. Eighty patients were diagnosed over a 6-year period. Twenty-two had biopsy proven cirrhosis while 58 others had portal hypertension with clinical and biochemical evidence of chronic liver disease. The commonest aetiology was alcohol (36%), followed by the idiopathic variety and hepatitis B. The male to female ratio was 4.4:1. Indians had a high prevalence of alcohol-associated chronic liver disease. Overall, ascites was the commonest presentation. Eight patients presented with hepatocellular carcinoma. Spontaneous bacterial peritonitis was diagnosed in 13% of patients undergoing abdominal paracentesis. Gallstones were detected in 37% of patients who underwent ultrasonography. Diabetes mellitus and peptic ulcer disease were noted in 22% and 31% of patients respectively.
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PMID:Chronic liver disease in Kuala Lumpur, Malaysia: a clinical study. 225 36

The results of a prospective series using the mesocaval interposition shunt (MIS) over a period of 13 years is reviewed. One hundred patients were selected for the operation using strict criteria, and in 98 cases the operation was performed electively. Selection criteria included a liver volume of between 1,000 and 2,500 ml, portal perfusion of between 15-30%, no active liver disease and no stenosis of hepatic artery or celiac axis, as well as a good functional Child-Pugh classification (A-B). In all the cases preoperative sclerotherapy was performed as many times as needed with the aim of controlling the active bleeding at admission and of diminishing the pre- and postoperative bleeding probability. Intra-operative postshunt measurements showed residual portal perfusion in all patients studied. Early mortality was 10% and the follow-up mortality 38.8%. The main causes of death were liver failure and hepatocellular carcinoma. The five- and ten-year survival rates were 65% and 35%, respectively. The total encephalopathy rate was 12.2%. Rebleeding was observed in 5.5% of the cases, and the long term-shunt patency rate was 90%. Anigography and sequential scintigraphy showed residual portal perfusion in 75% of the cases soon after operation, in 60% after 6 months, and in 38% after 2 years, showing the tendency of the diversion to diminish the portal perfusion rate in the late postoperative period. The results show that MIS still has a place in the treatment of portal hypertension and that it is an excellent alternative choice to the selective shunts and the devasculariaztion procedures.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Analysis of a prospective series of 100 mesocaval interposition shunts for bleeding portal hypertension. 231 35

The results of injection sclerotherapy for oesophageal varices which recurred after portal non-decompressive surgery were analysed retrospectively to evaluate its efficacy. We treated 60 consecutive patients with portal hypertension; 19 were treated on an emergency basis, seven electively and 34 on a prophylactic basis. All acute bleeding was controlled with one session of sclerotherapy using a transparent overtube. After eradication by sclerotherapy, no bleeding episodes occurred and there was no recurrence of the varices, except in three uncompliant patients, during a mean follow-up period of 33.1 months. Bleeding from a gastric ulcer and gastritis occurred in one patient each. Oesophageal stenosis occurred in nine (15 per cent) patients and gastric varices developed in two (3 per cent) patients. Twelve patients died, five from liver failure and six with hepatoma, but there was no bleeding from the gastrointestinal tract. The overall 4-year survival rate was 80 per cent. We recommend the use of sclerotherapy as the primary treatment for recurrent oesophageal varices.
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PMID:Eradication of oesophageal varices recurring after portal non-decompressive surgery by injection sclerotherapy. 239 24

Vessels around the intrahepatic large bile ducts (peribiliary vascular plexus) were examined by histologic, immunohistochemical and scanning electron microscopic observations. The vessels within duct walls were mainly capillaries, while those around the duct walls were composed of capillaries and venules. A majority of vessels was positive for factor VIII-related antigen and Ulex europaeus lectin I. Scanning electron microscopy of hepatic arterial and biliary casts revealed that bile ducts were surrounded by the vascular plexus derived from hepatic arterial branches, and serial section observations in addition disclosed the vessels connecting the peribiliary plexus with portal venous branches ('internal roots'). The peribiliary vascular plexus was increased considerably in livers with portal hypertension, especially idiopathic portal hypertension, extrahepatic portal venous obstruction and hepatocellular carcinoma with portal venous tumor thrombi. Internal roots were also frequently found in the livers with portal hypertension. These results suggest that altered intrahepatic hemodynamics in portal hypertensive conditions involves the peribiliary vascular plexus, resulting in an increase of the number and frequent occurrence of 'internal roots', these vessels probably operating as intrahepatic collaterals.
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PMID:Vascular plexus around intrahepatic bile ducts in normal livers and portal hypertension. 254 Nov 96

Hepatocellular carcinoma is closely associated with cirrhosis, but it also develops, although much less frequently, in a noncirrhotic liver. It is suspected, without supporting evidence, that hepatocellular carcinoma has a different etiology when associated and not associated with chronic liver disease. In this study, 66 noncirrhotic cases found among 618 autopsies for hepatocellular carcinoma (10.7%) were analyzed retrospectively. The noncirrhotic liver was histologically unremarkable in 3 cases and in the histologically evaluable 56 cases it had fibrosis of varying degrees or mild cellular infiltrate, or both, in the portal tract. There was one liver that had portal venous changes compatible with those in idiopathic portal hypertension (Banti's syndrome). In these noncirrhotic livers, the parenchymal cells were generally unremarkable except for liver cell dysplasia that was seen in 26.8%. Serum hepatitis B surface antigen was positive in only 7.4% in contrast to 26.6% in cirrhotic cases. Three histologically unremarkable cases had no clinical or histologic evidence of chronic liver disease; two involved painter-plasterers and one a farmer. The liver weight in these cases ranged from 4400 to 6180 g. In contrast, the average liver weight in cirrhotic cases was 1998 g. Noncirrhotic patients when compared with cirrhotic patients had better liver function tests and much less frequent varices. It was concluded that approximately 11% of hepatocellular carcinoma cases in Japan are noncirrhotic, the majority having some histologic changes in the portal tracts suggestive of past or ongoing chronic liver disease, and that there are rare cases that have no histologic changes in the liver.
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PMID:Hepatocellular carcinoma without cirrhosis in Japanese patients. 254 16

Intermittent hepatic artery occlusion combined with infusion chemotherapy is a newly devised methodology. A double lumen balloon catheter was surgically inserted into the hepatic artery. Through the catheter, fluorouracil (5-Fu) was continuously infused and mitomycin (MMC) or adriamycin (ADM) was injected in one-shot at the time of blood flow occlusion. This new methodology was performed in 19 patients who had unresectable hepatocellular carcinoma. Although five of 19 cases had arterioportal (A-P) or arteriovenous (A-V) shunts, four of them also responded well and objective anti-tumor effects resulted. In addition, complications associated with A-P or A-V shunts such as bleeding from the digestive tract due to portal hypertension were well managed by this new methodology.
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PMID:[Clinical studies of intermittent hepatic arterial occlusion with infusion chemotherapy for unresectable hepatocellular carcinoma associated with arterioportal or arteriovenous shunts]. 254 51

A 53-year-old man with an arteriovenous malformation of the pancreas associated with extensive mesenteric varices, liver cirrhosis, and hepatocellular carcinoma with arterioportal shunting was diagnosed by angiography. This is the first report of such a case with portal hypertension.
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PMID:Arteriovenous malformation of the pancreas associated with mesenteric varices: case report and review of the literature. 254 33

Gallbladder wall thickness (GBWT) and serum albumin were determined in 54 patients with ascites. The statistical analysis of the results reveals a significant difference in GBWT between benign and malignant conditions (p less than 0.01). GBWT was significantly thicker in patients with cirrhosis than in those with malignant ascites (p less than 0.01) and other benign conditions. However, no significant differences were found between either cirrhotic cases with and without overlying hepatocarcinoma, or between noncirrhotic patients, malignant or otherwise. On comparing GBWT and simple routine sonography in establishing the etiology of ascites, the diagnostic reliability indices decreased with GBWT. This shows that GBWT determination lacks diagnostic importance in routine practice. No correlation was found between serum albumin and GBWT, which suggests that the increase in GBWT observed in cirrhotic patients is mainly the result of accompanying portal hypertension.
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PMID:Sonographic relationship between gallbladder wall thickness and the etiology of ascites. 255 May 22


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