Success of microvascular surgery; repair mesenteric injury and prevent short bowel syndrome: a case report

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Autoimmune Pancreatitis and Treatment Approaches with Case Reports

WOS: 000315000900018PubMed ID: 25207048Objective: In this study, we aimed to review retrospectively the data of 10 patient who were treated and followed-up in our clinic and to review the current approaches in the diagnosis and treatment of autoimmune pancreatitis (AIP). Material and Methods: We reviewed 10 patients retrospectively who were operated on and had the diagnosis of AIP histopathologically in the Ege University School of Medicine Department of General Surgery. Results: Between June 2001-November 2010, 10 patients who were diagnosed as AIP were examined retrospectively. Radiologically, a pancreatic mass was found in the pancreatic head with ultrasound in 7 (70%) of 10 patients and suspicious lesions were identified in the head of the pancreas in 3 (30%) patients. All patients were operated on in our clinic with the preliminary diagnosis of pancreatic head tumor; 8 patients underwent Whipple's procedure, 1 patient underwent pylorus preserving pancreaticoduodenectomy, and in 1 patient an exploratory pancreatic biopsy (frozen section) was carried out. Conclusion: Autoimmune pancreatitis is a disease with increasing incidence and characterized by lymphoplasmocytic cell infiltration and fibrosis. Patients with a pancreatic mass, if there is an autoimmune disease or chronic pancreatitis suspected in the detailed history, it is necessary to evaluate patients in terms of AIP serologically to protect the patients from an incoorectng diagnosis and morbidity of surgery

Unusual treatment of Kasabach-Merritt syndrome secondary to hepatic hemangioma: embolization with bleomycin

WOS: 000356802200012PubMed ID: 25471004Kasabach-Merritt syndrome (KMS) is a rare complication of cavernous hemangiomas characterized with anemia, thrombocytopenia, and consumption coagulopathy. This syndrome usually develops due to superficial soft tissue hemangiomas in infancy and childhood. KMS developing secondarily to hepatic hemangioma is very rare. In this report, we aimed to present the treatment of KMS developing secondarily to giant cavernous hemangioma of the liver with transarterial chemoembolization using bleomycin

Hepatic artery pseudoaneurysm as a cause of gastrointestinal system bleeding: A case report with a brief review of the literature

WOS: 000317376400028PubMed ID: 23864456A hepatic artery pseudoaneurysm is, by definition, a pulsatile hematoma due to a leakage of blood through a tear or disruption of the arterial wall, and the blood is contained only by the hepatic parenchyma or surrounding hematoma. It can be a very rare cause of gastrointestinal system bleeding. These pseudoaneurysms are usually very well managed by angiographic intervention. However, in some cases, surgery is inevitable. Herein, we present a 63-year-old female presenting with gastrointestinal system bleeding 45 days after surgery for cholangiocarcinoma. She was found to be bleeding from a pseudoaneurysm of the hepatic artery and underwent surgical intervention

Glasgow coma scale and APACHE-II scores affect the liver transplantation outcomes in patients with acute liver failure

WOS: 000328005900004PubMed ID: 24322743BACKGROUND: The timing and selection of patients for liver transplantation in acute liver failure are great challenges. This study aimed to investigate the effect of Glasgow coma scale (GCS) and APACHE-II scores on liver transplantation outcomes in patients with acute liver failure. METHOD: A total of 25 patients with acute liver failure were retrospectively analyzed according to age, etiology, time to transplantation, coma scores, complications and mortality. RESULTS: Eighteen patients received transplants from live donors and 7 had cadaveric whole liver transplants. The mean duration of follow-up after liver transplantation was 39.86 +/- 40.23 months. Seven patients died within the perioperative period and the 1-, 3-, 5-year survival rates of the patients were 72%, 72% and 60%, respectively. The parameters evaluated for the perioperative deaths versus alive were as follows: the mean age of the patients was 33.71 vs 28 years, MELD score was 40 vs 32.66, GCS was 5.57 vs 10.16, APACHE-II score was 23 vs 18.11, serum sodium level was 138.57 vs 138.44 mmol/L, mean waiting time before the operation was 12 vs 5.16 days. Low GCS, high APACHE-II score and longer waiting time before the operation (P<0.01) were found as statistically significant factors for perioperative mortality. CONCLUSION: Lower GCS and higher APACHE-II scores are related to poor outcomes in patients with acute liver failure after liver transplantation