Right Lobe Of Liver Research Articles

Effect of Portal Vein Types on Estimated Remnant Volume in Living Donor: Preoperative CT Assessment.

The aim of this study is to examine the effect of portal vein types on the ratio of the right-left lobe liver volumes, as well as the insufficient estimated remnant liver volume (ERLV) during the preoperative assessment of donor candidates for right-lobe liver transplantation. The preoperative abdominal CT examinations of the donor candidates in a single institution between December 2018 and May 2022 were retrospectively evaluated. Portal vein types are divided into 3; classical anatomy was considered type 1, PV trifuction was considered type 2, and if the first branch arising from the main portal vein is the right posterior branch, it was accepted as type 3. Other configurations were defined as type 4. The total, right-left lobe liver volumes, the ERLV, and the portal vein variations were noted. The chi-square test was performed to assess the correlation between portal vein types, the ratio of the right-left lobe volumes, andthe ERLV ratio below 30%. Tamhane's T2 post hoc tests were performed for pairwise comparison to assess the right-left lobe volume ratio among groups. 287 donor candidates (mean age, 35years ± 8.2; 174 men) were evaluated. The volume ratio of median volume of the right and left lobe was significantly higher in candidates with type 3 portal veins compared to those with type 1 portal veins (2 (1.3-3.5) and 2.1 (1.6-3.2), respectively, p = 0.017). The ERLV ratio below 30% was significantly higher in donor candidates with type 3 portal veins (42.9%) compared to those with type 1 and 2 portal veins (24.6%, 20%)) respectively, p = 0.030). Due to its propensity to result in insufficient ERLV in the donor, the presence of a type 3 portal vein should be evaluated during the preoperative evaluation. Secondary abstract: This study suggests that donor candidates with type 3 portal vein exhibit a notable rise in the frequency of insufficient remnant liver volume during the preoperative assessment.

Clinical insights into liver abscess: a comprehensive analysis of presentation, etiology and management in Northeastern India, Silchar, Assam

Hepatic abscess is a prevalent disease in Northeastern India with a myriad clinical feature. The present study is aimed to understand the clinical profile, microbiological aetiologies, and management outcomes in patients with hepatic abscesses in Northeastern India, Silchar. In the surgery department of Silchar medical college and hospital, 20 cases of hepatic abscess were studied from January 2022 to October 2023. Records were kept for history, examination, and laboratory investigations. Ultrasound-guided aspiration of the abscess was done, and samples were subject to relevant investigation. The mean age of patients was 33 years, 2/3rd of the patients were from lower socioeconomic status. Alcoholic history was elicited from 45% of the patients. The abscesses were predominantly in the right lobe (70%) and solitary (65%). Etiology of the cases, 55% amoebic, 40% pyogenic, and 5% were tubercular in origin. Pigtail catheterization was done in 70% of the patients; percutaneous needle aspiration was done in 25% of the cases. No cases of mortality were noted. Amoebic and tubercular abscess were solitary in nature whereas pyogenic abscesses were multiple. The amoebic and pyogenic abscess had right lobe predominantly affected whereas in tubercular abscesses left lobe involvement was more common. The most common presentation was young male of low socioeconomic status having solitary amoebic abscess usually in the right lobe of liver

The Difficulties of Diagnosis Giant Angiomyolipoma of the Liver: Clinical Case and Literature Review

Purpose: To report a clinical case demonstrating difficulties of diagnosis and successful surgical treatment of myomatous type of angiomyolipoma of the liver without simultaneous damage to the kidneys.Material and methods: A female patient, 49 years old, was admitted to the hospital in August 2023, had no specific complaints, an abdominal ultrasound revealed extraperitoneal extraorgan mass in the epigastrium and mesogastrium and masses in the right lobe of liver, most likely hemangioma. The contrast-enhanced MSCT was performed on admission. Patient was rehospitalized for a surgery in September. During the operation the tumor was removed and sent for histological examination, a further immunohistochemical study was also carried out.Results: According to the results of MSCT in S3, S4, S5 of the liver oval-shaped mass (198×104×177 mm) with heterogeneous density and solid, cystic and fat features was found. Three hypovascular hypodense inclusions sizes up to 11 mm was also identified in S7/8. There was no pathologic formation in the kidneys. The liver tumor was surgically removed, the resected material was directed to a scheduled histological examination. To confirm the diagnosis an IHC analysis was also done and it revealed the expression of melanocytic (HBM-45) and smooth muscle (SMA) markers.Discussion: In this case we encountered very sparsely described in the world literature localization of angiomyolipoma — isolated hepatic one (without kidney damage). Like other authors we encountered the similarity of muomatous tumor type to the HCC and adenoma of the liver due to the characteristic features of visualization: hypervascularity, early contrast enhancement into an arterial phase and reduced density relative to the preserved parenchyma of the liver into a delayed phase of contrast.Conclusion: This case demonstrates the difficulty of diagnosing the myomatous type of AML simulating the HCC. As one of the most informative methods of diagnosis, we single out MSCT, which allowed us to think about the possibility of a benign nature of the tumor. In our case the main features excluding HCC were the absence of rapid “washout” of contrast drug, the presence of lipomatous areas and no accumulation of contrast agent by the capsule.

Liver Infiltration From a Huge Renal Cell Carcinoma: A Diagnostic and Management Enigma

Renal Cell Carcinoma (RCC) is the most lethal malignancy of urinary tract. Invasion of right lobe of liver by RCC is rare and possess a treatment challenge. Simultaneous nephrectomy with right hepatectomy has been proposed as a part of multi-modality treatment approach. We herein discuss a patient who underwent simultaneous nephrectomy with right hepatectomy along with single peritoneal metastasectomy for a huge RCC of right kidney and infiltrating the right lobe of liver. A 30- year old female was diagnosed with a right renal tumor invading into the right hepatic lobe. Post multi-disciplinary tumor board meeting she was planned for surgical intervention. Intra-operatively a single peritoneal nodule was present which came positive for malignancy on frozen section. Considering young age, good performance status and oligometastatic disease definitive procedure in the form of combined right nephrectomy and right hepatectomy was performed. She was discharged from the hospital on 6th post-operative day with an uneventful post-operative course. This type of RCC has been rarely reported and the combined nephrectomy and right hepatectomy is safe and feasible for this type of huge RCC invading right hepatic lobe.

Comparative Anatomical and Histological study of gall bladder in Mallard (Anas platyrhynchos) and Broiler fowl (Gallus gallus )

The current study was investigated anatomical and histological description of gall bladder of two specious which different in nutrition and life habitat Mallard (Anas platyrhnchos) aquatic life bird, and broiler fowl (Gallus gallus) wild life bird ,used ten bird of each specious ,anatomical result founded the gall bladder is located at the visceral surface right lobe of liver at right side of abdominal cavity, and composed of three parts head, neck and body, gall bladder in both specious appeared with dark green color. Gall bladder of mallard has balloon shape more elongated organ while in Gallus gallus is pear shape, the mean weight of gall bladder in mallard (1.91±0.56 g) , length (3.07±0.505 cm) and width (3.07±0.5 cm ) while broiler fowl weight of gall bladder (8.24±2.88 g), length (3.31±0.8 cm)and width (3.56±1.32 cm ) .Histologically; Gall bladder in mallard has three main layers: tunica mucosa, tunica muscularis and tunica adventitia ,tunica mucosa which lined by simple columnar epithelium non-ciliated with goblet cells and the lamina propria-submucosa composed of loos connective tissue , tunica muscularis was a thick layer of muscles (smooth muscles) and adventitia made of loos connective tissue , while gall bladder of Gallus gallus domesticus has three layer; tunica mucosa, lamina propria -submucosa, tunica muscularis and adventitia , tunica mucosa which lined by simple columnar epithelia non- ciliated without goblet cells , with present lamina propria -submucosa fused with lamina propria ,and thin layer of tunica muscularis and adventitia made of loos connective tissue .

Frequency of Esophageal Varices in Chronic Liver Disease Patients & its Relationship to Mean of Ratio of Right Lobe of Liver to Serum Albumin Concentration

Frequency of Esophageal Varices in Chronic Liver Disease Patients & its Relationship to Mean of Ratio of Right Lobe of Liver to Serum Albumin Concentration

Frequency of Esophageal Varices in Chronic Liver Disease Patients & its Relationship to Mean of Ratio of Right Lobe of Liver to Serum Albumin Concentration

Frequency of Esophageal Varices in Chronic Liver Disease Patients & its Relationship to Mean of Ratio of Right Lobe of Liver to Serum Albumin Concentration

A preliminary study on the effect of renal function on the metabolism of 18F-FDG in the human cerebellum.

The cerebellum is less affected by normal aging or neurodegenerative diseases, the aim of this paper is to investigate the effect of renal function status on uptake of 2-deoxy-2-[18F]fluoro-D-glucose (18F-FDG) in human cerebellum based on independent creatinine (CRE) or blood urea nitrogen (BUN) levels. A total of 253 patients who underwent 18F-FDG PET/CT scans were included. The patients were divided into groups according to renal function status: 201 patients with normal renal function, 16 patients with increase CRE, 36 patients with decrease CRE, and 31 patients with abnormal BUN. The maximum standardized uptake values were obtained in regions of interest (ROIs) for multiple tissue types (right cerebellum, right lobe of liver, right lung, bone marrow and psoas muscle at the level of the fourth lumbar vertebra). Moreover, the selected normal CRE groups were pair-matched with CRE decrease group with respect to age, sex, body mass index and glucose, respectively. Among 253 patients who met the inclusion/exclusion criteria, the final analysis included 967 ROIs (244 cerebellum, 191 lungs, 230 muscles, 145 bone marrow, and 157 liver) from 18F-FDG PET/CT scans. Among patients grouped by CRE or BUN levels, the uptake of 18F-FDG by cerebellum was significantly decreased in patients with CRE decrease level (P=0.001). There were no statistically significant differences between the other groups. Matched-pair analysis indicated there were no significant changes in outcomes between the CRE decrease group and the age-, sex-, BMI-, and glucose-matched controls compared to pre-matching. In patients with normal renal function and reduced CRE concentration, decrease cerebellar glucose metabolism was observed; however, no abnormal uptake of 18F-FDG was found in the cerebellum and other normal tissues of patients with impaired renal function. Consequently, in the study of cerebellar 18F-FDG metabolism, it may be necessary to consider the influence of blood CRE level.

Dynamic contrast-enhanced CT and clinical features of sarcomatoid hepatocellular carcinoma

PurposeTo investigate the dynamic contrast-enhanced computed tomography (CECT) features and clinical characteristics of sarcomatoid hepatocellular carcinoma (S-HCC).MethodsWe retrospectively reviewed the CECT data and clinical findings of 13 patients (11 male and 2 female, with an average age of 58.6 ± 11.2 years) with pathologically proven S-HCC, including 9 patients with surgical resection and 4 patients with biopsy examination. All patients underwent CECT scans. Two radiologists reviewed and evaluated general features, CECT features and extratumoral features of each lesions based on a consensus.ResultsAmong the thirteen tumors, a mean size of 66.7 mm was observed, ranging in diameter from 30 to 146 mm. Seven of thirteen patients had hepatitis B virus (HBV) infection and an elevation of alpha-fetoprotein (AFP) level. Most of cases located in the right lobe of liver (84.6%, 11/13). Nine of thirteen tumors showed lobulated or wavy contours and infiltrative morphology, while eight tumors presented with unclear margin. The tumor textures were mainly heterogeneous for ischemia or necrosis, with solid components dominantly in all cases. Eight of thirteen tumors exhibited “slow-in and and slow-out” dynamic enhancement pattern in CECT, with a enhancement peak in the portal venous phase. Portal vein or hepatic thrombus, adjacent organs invasion and lymph node metastasis were observed in two patients, respectively. Four of thirteen lesions occurred intrahepatic metastasis and hepatic surface retraction respectively.ConclusionS-HCC gengerally seen in elderly male with HBV infection and elevated AFP level. The CT manifestations including: large diameter, frequently hepatic right lobe involvement, lobular or wavy contours, ill-defined margins, infiltrative morphology, obvious heterogeneity and dynamic enhancement pattern of “slow-in and and slow-out” , contributed to the diagnosis of S-HCC. These tumors usually occurred hepatic surface retraction and intrahepatic metastasis.

An Early Experience of “Hanging Maneuver of Liver resection":A Cross-Sectional Study

Introduction The posterior approach to liver resection is technically difficult, especially when there is a bulky tumor or dense adhesion of right lobe of liver with the risk of tumor dissemination and hepatic vein avulsion. To prevent this, anterior approach of liver resection was used; however, it is technically challenging and can lead to a false line of transection and difficulty in controlling bleeding in deeper parenchymal plane. These technical difficulties are overcome by hanging maneuver liver resection which eases the process of anterior approach. The Objectives of our study were to observe the technical safety, operative duration, operative blood loss, and perioperative complications of hanging maneuver in liver resection. Methods This is a cross-sectional study on the patients who underwent hanging maneuver of liver resection at our center. The perioperative data were analyzed. Descriptive variables were described using frequency and percentage; continuous variables were described using mean and standard deviation. Results A total of 15 patients underwent hanging maneuver of liver resection, majority were male (66.6%) with Child-Pugh score-A of 80%. The most common indication was complex hydatid cyst of liver (33%) and biliocutaneous fistula (13%) that occurred after previous intervention for hydatid cyst of liver (13%). Intraoperative blood loss was 750±343.2 ml and complications grade IIIA were up to 20% as per Clavien Dindo grading system. Conclusions Hanging maneuver of liver resection is a technique that facilitates in elevating liver parenchyma away from IVC and helps in an easier anterior approach. A learning curve and assessment of background liver disease is necessary for its safety.

Evaluation of right liver lobe size to serum albumin concentration ratio in predicting the presence of esophageal varices in cirrhotic patients taking endoscopy as gold standard

Background: Cirrhosis with its complication is a major health concern in Pakistan. Endoscopy is an invasive and expensive modality for screening for esophageal varices which is one of the most common complication of liver cirrhosis. Research is being conducted to explore non-invasive markers that can replace this invasive technique. We aimed to evaluate the predictive value of the ratio of the size of the right lobe of liver to serum albumin concentration in prediction of the presence of esophageal varices.
 Methods: It was a cross-sectional study conducted at the Medicine Department, Ghurki Trust Teaching Hospital, Lahore from January 4 till July 31. The study included 297 patients of all the genders, aged 20-70 years, diagnosed cases of liver cirrhosis for at least 6 months and having suspected esophageal varices on right liver lobe size to serum albumin ratio >4.1. All the patients were subjected to upper GI endoscopy to confirm predicted varices. Data was analyzed using SPSS 23.0. PPV of the ratio was calculated. Post-stratification chi square was used to find association (p value <0.05 as significant).
 Results: The patients had a mean age of 51.5 ± 9.2 years with 180 (60.6%) male and 117 (39.4%) female patients. Diagnosis of esophageal varices was confirmed in 225 (75.8%) patients on endoscopy. There were 225 true positive and 72 false positive cases. Positive predictive value was 75.8%.
 Conclusion: The positive predictive value of the ratio of the size of the right liver lobe to serum albumin was statistically significant in predicting the presence of esophageal varices on upper GI endoscopy. These findings were not dependent on the patient's age, BMI, gender, duration of disease or serum bilirubin level.
 
 Cirrhosis, Esophageal Varices, Right Liver Lobe Diameter to Serum Albumin Ratio

Caroli’s Syndrome in a 5½-Year-Old Bangladeshi Girl: A Case Report

Caroli’s syndrome is a rare inherited disorder characterized by multiple segmental cystic or saccular dilatation of the intrahepatic bile duct associated with congenital hepatic fibrosis. Symptoms of Caroli’s syndrome may appear early or late during life and its presentation is highly variable. Portal hypertension followed by development of oesophageal varices is the main consequence of congenital hepatic fibrosis. Up to 60% of Caroli’s syndrome patients are associated with renal involvement. The diagnosis of Caroli’s syndrome mainly depends on histology and imaging method that can show the communication between bile ducts and saccule. Important complication is cholangitis and later may progress to cholangiocarcinoma. For symptomatic Caroli’s syndrome, liver transplantation is the only curative treatment. Here, we report a case of Caroli’s syndrome in a 5½ year old girl admitted in the department of Pediatric Gastroenterology and Nutrition, BSMMU with the complaints of abdominal distension since birth. Her CT scan report showed type V choledochal cyst with large cyst in right lobe of liver and polycystic kidney disease. Endoscopy of upper GIT revealed grade II oesophageal varices and MRCP also suggested Caroli’s disease (Type V choledochal cyst). Finally, she was diagnosed as a rare case of Caroli’s syndrome (Type V choledochal cyst with grade II oesophageal varices with polycystic kidney disease). J Enam Med Col 2021; 11(1): 55-58

Assessment of Liver Regeneration in Patients Who Have Undergone Living Donor Hepatectomy for Living Donor Liver Transplantation.

Inflammation and the associated immune pathways are among the most important factors in liver regeneration after living donor hepatectomy. Various biomarkers, especially liver function tests, are used to show liver regeneration. The aim of this study was to evaluate the course of liver regeneration following donor hepatectomy (LDH) by routine and regeneration-related biomarkers. Data from 63 living liver donors (LLDs) who underwent LDH in Inonu University Liver Transplant Institute were prospectively analyzed. Serum samples were obtained on the preoperative day and postoperative days (POD) 1, 3, 5, 10, and 21. Regenerative markers including alfa-fetoprotein (AFP), des carboxy prothrombin (DCP), ornithine decarboxylase (ODC), retinol-binding protein 4 (RBP4), and angiotensin-converting enzyme isotype II (ACEII) and liver function tests including alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP) and total bilirubin levels were all analyzed. The median age of the LLDs was 29.7 years and 28 LLDs were female. Eight LLDs developed postoperative complications requiring relaparotomy. The routine laboratory parameters including AST (<0.001), ALT (<0.001), ALP (<0.001), and total bilirubin (<0.001) showed a significant increase over time until postoperative day (POD) 3. For the regeneration-related parameters, except for the RBP4, all parameters including ACEII (p = 0.006), AFP (p = 0.002), DCP (p = 0.007), and ODC (p = 0.002) showed a significant increase in POD3. The regeneration parameters showed a different pattern of change. In right-lobe liver grafts, ACEII (p = 0.002), AFP (p = 0.035), and ODC (p = 0.001) showed a significant increase over time. DCP (p = 0.129) and RBP4 (p = 0.335) showed no significant changes in right-lobe liver grafts. Regenerative markers are increased in a sustained fashion following LDH. This is more prominent following right-lobe grafts which are indicative of progenitor-associated liver regeneration.

A comparison of transient elastography with acoustic radiation force impulse elastography for the assessment of liver health in patients with chronic hepatitis C: Baseline results from the TRACER study.

Liver stiffness measurements can be used to assess liver fibrosis and can be acquired by transient elastography using FibroScan® and with Acoustic Radiation Force Impulse imaging. The study aimed to establish liver stiffness measurement scores using FibroScan® and Acoustic Radiation Force Impulse in a chronic hepatitis C cohort and to explore the correlation and agreement between the scores and the factors influencing agreement. Patients had liver stiffness measurements acquired with FibroScan® (right lobe of liver) and Acoustic Radiation Force Impulse (right and left lobe of liver). We used Spearman's correlation to explore the relationship between FibroScan® and Acoustic Radiation Force Impulse scores. A Bland-Altman plot was used to evaluate bias between the mean percentage differences of FibroScan® and Acoustic Radiation Force Impulse scores. Univariable and multivariable analyses were used to assess how factors such as body mass index, age and gender influenced the agreement between liver stiffness measurements. Bland-Altman showed the average (95% CI) percentage difference between FibroScan® and Acoustic Radiation Force Impulse scores was 27.5% (17.8, 37.2), p < 0.001. There was a negative correlation between the average and percentage difference of the FibroScan® and Acoustic Radiation Force Impulse scores ( r (95% CI) = -0.41 (-0.57, -0.21), p < 0.001), thus showing that percentage difference gets smaller for greater FibroScan® and Acoustic Radiation Force Impulse scores. Body mass index was the biggest influencing factor on differences between FibroScan® and Acoustic Radiation Force Impulse (r = 0.12 (0.01, 0.23), p = 0.05). Acoustic Radiation Force Impulse scores at segment 5/8 and the left lobe showed good correlation (r (95% CI) = 0.83 (0.75, 0.89), p < 0.001). FibroScan® and Acoustic Radiation Force Impulse had similar predictive values for the assessment of liver stiffness in patients with chronic hepatitis C infection; however, the level of agreement varied across lower and higher scores.

Accidentally Case of Chilaiditi’s Syndrome in COVID-19 Geriatric Patient

Chilaiditi’s syndrome is a rare disease with an incidence of 0.025-0.28% cases, where it shows colon interposition between diaphragm and right lobe of liver. Usually related to congenital malformation include the absence, weakness, or elongation of suspensory ligaments of transversal colon or falciform ligaments. The 83-year-old woman was admitted with 1-week history of fatigue, lacked the will to eat and drink. Nausea and vomiting were sometimes accompanied with abdominal pain. Patient often had difficulty in defecating even though she had been eating fruits, she often needed laxatives. Patient had a history of osteoarthritis and hypertension.Physical examination appeared moderately-ill, with gasglow coma scale (GCS) 14 and blood pressure 150/90 mmHg. From abdomen epigastric tenderness (+). From thoracic X-ray found visible interposition of colon at right-upper quadrant of abdomen. Geriatric index fall risk assessment = 11 and mini mental state examination (MMSE) = 22. This patient was a geriatric patient with multiple diagnosis and frailty. Patient had a history of osteoarthritis contributes to patient’s instability. Chronic constipation was also quite disturbing cause an interposition of colon. Patient had coincidence with COVID-19 with comorbidity and geriatric syndrome. Thorough care, close monitoring, and optimal management should be applied.

A CASE SERIES ON SURGICAL MANAGEMENT OF HYDATID CYST OF LIVER IN A TERTIARY CARE CENTRE OF EASTERN INDIA

Introduction: Hydatidosis, a zoonotic disease is still of major concern in developing countries. Although it can involve any organ, liver is most commonly affected. The diagnosis, apart from the varied history and physical signs, involves specic serological tests and radiological techniques. We present this case series to describe our institutional experience in managing this condition. This series was conducted at a Methodology: tertiary care center of eastern India from January 2021 to July 2022. All patients managed surgically with a denitive diagnosis of hydatid cyst of liver on computerised tomography (CT) scan with or without symptoms were included in the study. Open or laparoscopic cyst excision was performed and postoperatively followed till 3 months. The series had a male predomi Results: nance (72%) with 46.7 years being the mean age. Abdominal pain was the most consistent presenting complain (100%) followed by abdominal mass (40%). Right lobe of liver was involved in 76% cases. Surgical site infection (16%) followed by biliary leak (12%) was the most common postoperative complication encountered. The mean length of hospital stay was 10.1 days with 2 cases presenting with recurrence in the 3 month follow up period. This series highlights Conclusion: the clinical presentation, preoperative diagnosis and management of liver hydatidosis with an emphasis on the need of clinical suspicion. A knowledge of surgical approaches and post operative complications is necessary to appropriately tackle such cases.

Renal Artery Stenosis due to Entrapment

Common etiologies of renovascular occlusive disease include atherosclerosis disease, developmental fibrotic conditions such as fibromuscular dysplasia, and vasculitis. Extrinsic compression of the renal artery is a rarely reported phenomenon but can lead to similar clinical manifestations. We report recent experience with 2 patients who presented with extrinsic renal artery compression due to entrapment. Diagnosis was made with a constellation of findings on computed tomography angiography, dynamic duplex sonography, and catheter angiography. Both patients had hypertension and 1 had downstream subsegmental renal infarcts. The patients, both with right-sided renal artery entrapment, were treated with open surgical decompression. Exposure was achieved via extended Kocher maneuver followed by mobilization of the right kidney and, in 1 patient, detachment of the right lobe of liver to allow circumferential exposure of the proximal right renal artery to the aorta. All entrapping tissue was circumferentially released. Both operations were uncomplicated. Intraoperative sonography was used to confirm luminal patency of the released segments. Follow-up of renal artery duplex in both patients demonstrated resolution of dynamic compression. Renal artery peak systolic velocity and accelerations indices were all within normal limits. In both patients, improvement in blood pressure control was noted and discontinuation of anticoagulation was possible in the patient who had recurrent episodes of renal infarct. Extrinsic compression of renal artery by diaphragmatic crura is rare but should be considered in younger patients or otherwise any patients with no vascular risk factors when renovascular hypertension workup yields no demonstrable intrinsic disease. A high index of suspicion should be raised when an anomalously high origin of the renal artery or proximity to the diaphragmatic crura is seen on cross-sectional imaging. Work-up should include dynamic imaging to assess compression of renal arteries during expiration. Open surgical or laparoscopic decompression of the involved renal arteries can be curative.

Ultra sonographic study of right lobe of liver morphometry with age, sex, height, weight and BMI of individual in central Indian population

Correlation between craniocaudal length of right lobe of liver and age of subjects is not significant at 5% level of significance. Correlation between craniocaudal length of right lobe of liver and gender of subjects is significant at 5% level of significance, (p=0.00). Craniocaudal length of right lobe and height of subjects showing +ve correlation and correlation between ccl of rt lobe and height of subjects is significant at 5% level of significance. Craniocaudal length of right lobe and body mass index of subjects showing +ve correlation (r=0.356) and correlation between ccl of rt lobe and BMI of subjects is significant at 5% level of significance. Craniocaudal length of right lobe and weight of subjects showing +ve correlation (r=0.047) and correlation between ccl of rt lobe and weight of subjects is not significant at 5% level of significance.

Prospective study of clinical profile and various modalities of treatment in management of liver abscess

Background: Hippocrates described about liver abscess in 460-377 B.C. Liver abscess is term for a collection of purulent material in liver parenchyma, which is due to bacterial, fungal, parasitic or mixed infection.Aims and Objectives: To study the clinical profile of patients of liver abscess, causative factors, various treatment modalities and morbidity, mortality, prognosis associated with liver abscess.Material and Methods: Prospective Observational Study conducted in Department of General Surgery, Dr. V M G M C, and Solapur from Sep 2016 to Aug 2018. The sample size was 50 liver abscess cases. Results and Observations: In total, of 50 patients, according to age showed that maximum 36% of patients were from age group 21-30 years with male involvement was 72%. Maximum patients presented with fever with chills 68%. Alcoholic is the risk factor which constitute 68% with amoebic liver abscess is more common. Right lobe of liver involve more than left lobe. Percutaneous Aspiration + Antibiotics was most used treatment modality 36%. Conclusion: Young male with age group 21-30 year more commonly affected. Fever with chills presented by most number of liver abscess, chronic Alcohol intake is a definitive risk factor, percutaneous needle aspiration + Antibiotics is preferred in patients with single abscess of size >5 cm situated in superficial segments.

Extraintestinal Amoebiasis: Amebic Liver Abscess in a 48-Year-Old Male Patient

Background: The liver is the most common organ for abscesses. Liver abscesses can be solitary or multiple. Approximately 90% of right-lobe liver abscesses are solitary abscesses, while only 10% of left-lobe abscesses are solitary abscesses. This can occur from hematogenous spread or directly from the site of infection in the peritoneal cavity.&#x0D; Case presentation: A 48-year-old male patient had been administered into the internal medicine ward with the chief complaint of pain in the upper right quadrant of the abdominal increased 3 days before being admitted to the hospital. The patient also complains that pain increase when the patient moves forward and is influenced by activity. The patient walked like a person who carried his stomach. The patient complained of watery stools 3 months ago in ten days, which frequency two to three times a day. The stools are bloody and slimy. Swelling of an upper right quadrant of abdominal since 1 month ago. Decrease of appetite since 1 month ago. Decrease of body weight since 1 month ago, about 5 kilograms. Fever since 2 weeks ago, not high, disappearing, no chill, no sweat. Nauseous since 1 week ago. The patient was admitted to the hospital with awareness of compos mentis, cooperative, and his general condition appeared to be moderately ill, blood pressure 120/80 mmHg, pulse rate 86 times/minute, regular pulse, adequate filling, respiratory rate 24 times/minute, temperature 37ºC. On physical examination, the conjunctiva of the patient’s eyes was anemic. Entamoeba histolytica was found on a routine stool examination.&#x0D; Conclusion: The main clinical manifestations of amoebiasis are right abdominal pain can be features of iron deficiency anemia and reactive thrombocytosis. Diagnosis is based on the finding of characteristic Entamoeba histolytica in the stool. Metronidazole 500 mg three times daily dose resulted in 80% cure and a dose of 750 mg/three times daily for 10 days gave 100% cure. Treatment of reactive thrombocytosis is by curing the basic disease.