Portal Venous Structures Research Articles

Top tips regarding EUS-guided liver biopsy

Top tips regarding EUS-guided liver biopsy

Effects of fatty filtration at the pediatric liver hemodynamic changes evaluated by Doppler ultrasonography

Background: Hemodynamic changes in liver vascular structures of patients in the pediatric age group are evaluated by doppler ultrasonography. Material: Fifty- nine hepatosteatosis patients, classified as mild, moderate or severe, and 23 healthy volunteers were included in this 82-person study. The height, weight, liver size tests of the subjects were measured. Those values were compared in the patient and control groups. In the patient and control groups, color duplex Doppler ultrasonography was used to examine portal vein peak velocity, portal vein flow volume, hepatic artery resistive index (RI), hepatic artery pulsatility index (PI) and hepatic artery flow volume. Results: Similar to the degree of hepatosteatosis, increases in body mass index, liver size were statistically significant (p<0.05). The difference between portal vein peak velocity hepatosteatosis and control groups was found statistically significant. As the hepatosteatosis grade increased, there was no statistically significant decrease in hepatic arterial flow volume, portal vein flow volume, and total flow volume. Hepatic artery RI and PI values ​​were statistically significantly lower in the control group than the other groups (p <0.05). There was a significant mild decrease in the mild stool group compared to the middle steat group. Although the hepatic artery RI and PI values ​​did not differ statistically in the comparison of the hepatosteatosis group, there was a minimal increase in the RI and PI values ​​as the steatosis grade increased. Discussion: According to these results, as the level of steatosis increases, the changes in the portal venous structures become more prominent and the resistance increases in vascular structures.

Pseudo-Alcoholic Cirrhosis: An Interesting Case Of Amiodarone Induced Hepatotoxicity.

Amiodarone is a commonly used antiarrhythmic drug in clinical practice, despite its notoriety for causing serious adverse effects. Long-term therapy, even at low doses poses great risks to the patient. We report a case of amiodarone induced hepatotoxicity. BACKGROUND Amiodarone is a commonly used antiarrhythmic drug in clinical practice, despite its notoriety for causing serious adverse effects. Long-term therapy, even at low doses poses great risks to the patient. CASE REPORT A 77-year-old female presented with increasing abdominal distension, weakness, nausea and vomiting, lethargy and confusion. Medical history was pertinent for atrial fibrillation, treated with amiodarone 200 mg daily for four years. Patient was known to have mildly elevated liver transaminases (less than 2 times of upper limit of normal) that were monitored by semi-annual transaminases. Physical exam was remarkable for fluctuating levels of mental status, asterixis, irregular heart rhythm, abdominal distension with a positive fluid thrill. Lab studies showed Hb-11.5, platelets-112, AST-192, ALT-162, ALK PHOS-122, reversal of albumin-globulin ratio, and prolonged prothrombin time. Abdominal paracentesis revealed transudative ascites with a high serum-ascites albumin gradient. Further work up revealed negative serology for ANA, anti-smith antibody, hepatitis A, B and C virus panel, normal alpha-1 antitrypsin and ferritin levels. A transjugular needle biopsy of the liver revealed mixed inflammation with neutrophilic satellitosis, numerous Mallory hyaline bodies (figure 1), and foam cells likely representing phospholipidosis (figure 2). The wedge hepatic pressure was 40 mmHg, free hepatic pressure was 23 mmHg, and gradient was 17 mmHg consistent with portal hypertension. The hepatic and portal venous structures were patent. Figure 1 Figure 1: Tranjugular Liver biopsy showing hepatitis with Mallory’s hyaline (arrow ) and minimal macrovesicular steatosis.

Newer ultrasonographic anatomy in the upper abdomen: I. The portal and hepatic venous anatomy.

Gray scale ultrasonography has made it possible to identify hepatic and portal venous structures. Single sector sweep scanning is important in depicting these structures. Identification of venous structures is discussed as well as methods for distinguishing large veins from pathologic structures.