87 research outputs found
First report of a gallbladder hemangioma coexisting with gallstones: a case report and literature review of a rare finding
BACKGROUND: Gallbladder hemangioma is an exceptionally rare entity, with only ten cases reported in literature hitherto. The here described case is the first report of a gallbladder hemangioma coexisting with gallstones. CASE PRESENTATION: A 76-year-old male was hospitalized following repeated episodes of epigastric pain. Patientâs medical history included primary hypertension, type 2 diabetes mellitus, dyslipidemia, obesity and hyperuricemia. Physical examination revealed marked pain in the right hypochondriac region, and laboratory workup was notable for mildly elevated glycemia (125Â mg/dL) and pancreatic amylase (60Â IU/L). Abdominal ultrasound showed multiple gallstones, a thickened gallbladder wall and mild edema of the perivisceral adipose tissue as well as a hepatic angioma. During surgery, an incidental subserosal nodule of about 1Â cm was detected within the gallbladder fundus. After surgery, the clinical course was uneventful and the patient was discharged. Histopathological examination of the subserosal nodule showed multiple dilated vascular channels within a sclerosing matrix, a finding consistent with a cavernous hemangioma. Diffuse chronic cholecystitis was also present. CONCLUSIONS: Gallbladder hemangiomas represent a rare, likely underdiagnosed condition which can be undetected during the preoperative workup
Outcome of liver transplantation with grafts from brain-dead donors treated with dual hypothermic oxygenated machine perfusion, with particular reference to elderly donors
Prompted by the utilization of extended criteria donors, dual hypothermic oxygenated machine perfusion (DâHOPE) was introduced in liver transplantation to improve preservation. When donors after neurological determination of death (DBD) are used, DâHOPE effect on graft outcomes is unclear. To assess DâHOPE value in this setting and to identify ideal scenarios for its use, data on primary adult liver transplant recipients from January 2014 to April 2021 were analyzed using inverse probability of treatment weighting, comparing outcomes of DâHOPEâtreated grafts (n = 121) with those preserved by static cold storage (n = 723). Endâischemic DâHOPE was systematically applied since November 2017 based on donor and recipient characteristics and transplant logistics. DâHOPE use was associated with a significant reduction of early allograft failure (OR: 0.24; 0.83; p = .024), grade â„3 complications (OR: 0.57; p = .046), comprehensive complication index (â7.20 points; p = .003), and improved patient and graft survival. These results were confirmed in the subset of elderly donors (>75âyearâold). Although DâHOPE did not reduce the incidence of biliary complications, its use was associated with a reduced severity of ischemic cholangiopathy. In conclusion, DâHOPE improves postoperative outcomes and reduces early allograft loss in extended criteria DBD grafts
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