1/389. Ischemic necrosis of bile ducts complicating Schonlein-Henoch purpura.Gastrointestinal complications of Schonlein-Henoch purpura are frequent and sometimes severe. However, there seem to be no reports of liver involvement. A child is described in whom Schonlein-Henoch purpura was complicated by bile duct lesions, resulting in biliary cirrhosis and requiring liver transplantation. At surgical removal, the liver had lesions of bile ducts and of adjacent small blood vessels in the hilum, very similar to those complicating hepatic artery thrombosis after liver transplantation. These findings suggest that Schonlein-Henoch purpura can be complicated by vasculitis of the peribiliary vessels resulting in ischemic necrosis of the bile ducts. Schonlein-Henoch purpura can be added to the list of causes of ischemic cholangiopathies.- - - - - - - - - - ranking = 1keywords = bile duct, bile, duct (Clic here for more details about this article) |
2/389. Necrotizing sialometaplasia.Two cases of necrotizing sialometaplasia are reported together with a review of the literature. This self-limiting benign lesion is easily confused with malignant tumors. The lesions are characterized histologically by an extensive necrosis of the salivary gland tissue together with squamous metaplasia of the ducts. The present report of two females who had intense pain in the initial phase differs from previous reports concerning age and symptoms. The importance of rather extensive biopsy specimens is stressed. Antibiotic treatment appears to be insignificant. A clinical history of allergy and a dominance of eosinophilic granulocytes in the inflammatory exudate in both cases may indicate an allergic etiology.- - - - - - - - - - ranking = 0.011703029066477keywords = duct (Clic here for more details about this article) |
3/389. Extrahepatic Hodgkin's disease with intrahepatic cholestasis: report of two cases.Liver is involved in about 5-8% of newly diagnosed Hodgkin's disease (HD) cases. The incidence reaches up to 50-60% in postmortem studies. In the literature only a few cases of idiopathic cholestatic jaundice have been described without an apparent cause and a paraneoplastic etiology has been suggested. We report 2 cases with HD presenting with obstructive jaundice without obvious liver involvement. The first case died soon after diagnosis; the second case received chemotherapy and radiotherapy, and she is well at 26 months' follow-up. Extrahepatic HD with intrahepatic cholestasis is an extremely rare situation without an established approach. Such cases like the present ones may help to understand the pathogenesis of the liver involvement of HD and determine the best management of these cases.- - - - - - - - - - ranking = 2.960856151086keywords = cholestasis (Clic here for more details about this article) |
4/389. Is the coexistence of mutations in the genes of factor v and MTHFR a predisposing factor for massive skin necrosis due to loxoscelism?A 28-year-old previously healthy man was diagnosed as having an extensive necrotic lesion of his calf due to loxoscelism. One year later he was diagnosed as having co-inheritance of mutations in factor v and methyl tetrahydrofolate reductase (MTHFR). This is the first report of a possible etiologic connection between loxoscelism necrotic lesions and thrombogenic diseases.- - - - - - - - - - ranking = 0.011703029066477keywords = duct (Clic here for more details about this article) |
5/389. Intraprocedural myocardial contrast echocardiography as a routine procedure in percutaneous transluminal septal myocardial ablation: detection of threatening myocardial necrosis distant from the septal target area.Percutaneous transluminal septal myocardial ablation (PTSMA) has been introduced as an alternative to surgery for symptomatic hypertrophic obstructive cardiomyopathy (HOCM). Visualization of the ablation area prior to induction of the chemical necrosis is possible by intraprocedural myocardial contrast echocardiography (MCE). We report on two patients in whom MCE showed opacification of the medial papillary muscle or the left ventricular posterolateral free wall. In both patients the correct ablation area could be identified by MCE after a change of the target vessel, thus avoiding potentially fatal complications due to induction of a necrosis of myocardium distant from the septal target area.- - - - - - - - - - ranking = 0.023406058132954keywords = duct (Clic here for more details about this article) |
6/389. Massive myocardial necrosis in thrombotic thrombocytopenic purpura: a case report and review of the literature.Thrombotic thrombocytopenic purpura (TTP) is an uncommon syndrome resulting from diffuse occlusion of small arterioles and capillaries by hyaline microthrombi. It is characterized by fever, thrombocytopenic purpura, microangiopathic hemolytic anemia, and neurologic and renal dysfunction. While cardiac pathology in TTP is commonly seen at autopsy, clinical cardiac dysfunction is rare and typically results from conduction system involvement. While 3% to 8% of patients with TTP report chest pain on admission, reports of fatal ventricular pump failure are extremely rare. We now report a case of TTP resulting in death from widespread myocardial necrosis. This patient presented with elevated cardiac enzymes and electrocardiographic disturbances that mimicked viral myocarditis, as well as a profound thrombocytopenia. Such a case may represent the extreme of a distribution of cardiac involvement in TTP or the consequence of an unidentified autoimmune process capable of precipitating severe myocardial TTP.- - - - - - - - - - ranking = 0.011703029066477keywords = duct (Clic here for more details about this article) |
7/389. Progressive perinatal bowel obstruction--a rare cause of short-bowel syndrome.A girl was born after an uneventful pregnancy of 36 weeks. Prenatally, distended bowel loops had been seen on ultrasound. Multiple small-bowel atresia was diagnosed and treated surgically. In the course of the next eleven weeks, previously patent segments of small bowel became obstructed. In 4 separate operative sessions, several segments of jejunum and ileum were resected, leaving 23 cm of ileum with the ileocecal valve in place. On microscopic examination of all resected material, necrosis of the mucosa was found consistent with ischemia. The child survived and tolerated full enteral feeding at the age of 8.5 months. The origin of the progressive obliterating process remains unknown.- - - - - - - - - - ranking = 0.27516644276781keywords = obstruction (Clic here for more details about this article) |
8/389. Hepatocellular carcinoma with spontaneous regression of multiple lung metastases.Spontaneously regressed lung metastasis of hepatocellular carcinoma (HCC) in a 82-year-old Japanese man with liver cirrhosis was recorded. Multiple nodular lesions of both lungs, up to 1 cm across, were shown on chest X-ray when the clinical diagnosis of HCC was made because of the presence of a liver mass on abdominal computed tomography (CT) scan and high serum alpha-fetoprotein (AFP) value. The lung lesions which were regarded clinically as metastasis of HCC decreased in number and size 7 months later, and subsequently disappeared a further 7 months radiographically. However, the liver mass revealed no reduction on abdominal CT, despite normalization of the serum AFP value, and the patient died 7 months after the disappearance of the lung lesions. The patient refused biopsy for the liver mass and anticancerous treatment during the course of the disease. At autopsy, the liver mass, 13 cm in diameter, histologically featured moderately differentiated HCC. Only one metastasis, 0.5 cm across, was obvious in the left lower lung lobe. In addition, there were 14 minute lesions in both lungs, up to 0.2 cm across, including three with complete necrosis and 11 with histocytic reaction and fibrosis. The necrotic tissue was filled with large ghostly cells that appeared to be debris from a neoplastic tissue, regardless of no viable tumor cells among them. The clinical and autopsy findings highly suggested that the patient developed spontaneous regression of multiple lung metastases of HCC and subsequently left the very small lesions as the vestige. Thus, the histology of these lesions may exhibit a process of the regression as the sequence of events, i.e., a transition from necrosis of the metastatic HCC to its fibrosis. Presence of an effective factor(s) in relation to the regression was unclarified. There has been no reported cases with regression of the only metastasis of HCC in the literature to date.- - - - - - - - - - ranking = 0.011703029066477keywords = duct (Clic here for more details about this article) |
9/389. Progressive tumor necrosis and lethal hyperkalemia in a neonate with sacrococcygeal teratoma (SCT).tumor lysis syndrome is known among patients undergoing induction therapy for lymphocytic malignancies. Spontaneous tumor lysis in patients with solid tumors is distinctly rare. To our knowledge, the phenomenon of spontaneous tumor lysis has been described only once in infancy, in association with the surgical manipulation of a hepatoblastoma. This is the first report of a newborn with sacrococcygeal teratoma who experienced spontaneous tumor lysis-induced hyperkalemia. Because cardiac arrest may be among the leading causes of operative mortality in babies with sacrococcygeal teratoma, intraoperative monitoring of serum K should be conducted frequently.- - - - - - - - - - ranking = 0.023406058132954keywords = duct (Clic here for more details about this article) |
10/389. Subacute hepatic failure associated with a new antidiabetic agent, troglitazone: a case report with autopsy examination.An autopsy case of fatal subacute hepatic failure after administration of troglitazone is described. The liver dysfunction developed about five months after the patient, a sixty-three-year-old woman, had been initially treated with troglitazone. The patient developed hepatic failure and died despite various hepatic auxiliary treatments such as plasmapheresis. autopsy findings revealed focal liver cell necrosis, cholestasis and steatosis with infiltration of lymphocytes and neutrophils and lack of regenerative activity. The causative mechanism of liver dysfunction may be metabolite aberration, as a result of accumulation of hepatotoxic metabolite(s), in a category of idiosyncratic liver injury. It is proposed to monitor liver function strictly and periodically for the diabetic patients prescribed troglitazone.- - - - - - - - - - ranking = 0.5921712302172keywords = cholestasis (Clic here for more details about this article) |
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