Giant extra-hepatic thrombosed portal vein aneurysm: a case report and review of the literature.

BACKGROUND: Extrahepatic Portal vein aneurysm (EPVA) is a rare finding that may be associated with different complications, e.g. thrombosis, rupture, portal hypertension and compression of adjacent structures. It is being diagnosed more frequently with the advent of modern cross-sectional imaging. Our review of the English literature disclosed 13 cases of thrombosed EPVA. CASE PRESENTATION: A 50-years-old woman presented with acute abdominal pain but no other symptom. She had no relevant medical history. Palpation of the right upper quadrant showed tenderness. Laboratory tests were unremarkable. A computed tomography showed portal vein aneurysm measuring 88 × 65 mm with thrombosis extending to the superior mesenteric and splenic vein. The patient was treated conservatively with anticoagulation therapy. She was released after two weeks and followed on an outpatient basis. At two months, she reported decreased abdominal pain and her physical examination was normal. A computed tomography was performed showing a decreased thrombosis size and extent, measuring 80 × 55 mm. CONCLUSIONS: Although rare, surgeons should be made aware of this entity. Complications are various. Conservative therapy should be chosen in first intent in most cases. We reported the case of the second largest thrombosed extra-hepatic PVA described in the literature, treated by anticoagulation therapy with a good clinical and radiological response

Facts, power and global evidence: a new empire of truth

What are the epistemological and political contours of evidence today? This introduction to the Special Issue on Global Evidence lays out key shifts in the contemporary politics of knowledge and describes the collective contribution of the five papers as an articulation of what we describe as a ‘new empiricism’, exploring how earlier historical appeals to evidence to defend political power and decision-making both chime with and differ from those of the contemporary era. We outline some emerging empirical frontiers in the study of instruments of calculation, from the evolution of the randomised controlled trial (RCT) to the growing importance of big data, and explore how these methodological transformations intersect with the alleged crisis of expertise in the ‘post-truth’ era. In so doing, we suggest that the ambiguity of evidence can be a powerful tool in itself, and we relate this ambiguity to the ideological commitment and moral fervour that is elicited through appeals to, and the performance of, evaluation

Traces of the future: an archaeology of medical science in Africa

This book presents a close look at the vestiges of twentieth-century medical work at five key sites in Africa : Senegal, Nigeria, Cameroon, Kenya, and Tanzania. The authors aim to understand the afterlife of scientific institutions and practices and the "aftertime" of scientific modernity and its attendant visions of progress and transformation. Straightforward scholarly work is juxtaposed here with altogether more experimental approaches to fieldwork and analysis, including interview fragments; brief, reflective essays; and a rich photographic archive. The result is an unprecedented view of the lingering traces of medical science from Africa's past