1/5. polyarteritis nodosa involving the hepatobiliary system in an eight-year-old girl with a previous diagnosis of familial mediterranean fever.polyarteritis nodosa (PAN) is a vasculitis of small- and medium-sized muscular arteries with deposition of immune complex in the vessel wall. Although gastrointestinal involvement is common, the symptomatic involvement of the hepatobiliary system is rare. An eight-year old female patient with a previous diagnosis of familial mediterranean fever (FMF) was hospitalized for right upper quadrant pain and fever. The thickened gall bladder wall by ultrasonography, called for exploration. Histopathological evaluations of the liver biopsy and gall bladder revealed PAN. Corticosteroid therapy was initiated and the patient recovered fully. This case represents one of the rarest forms of PAN in childhood.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/5. The use of a composite graft of iliac artery and inferior mesenteric vein in liver transplantation.Innovation may be required for satisfactory arterial reconstruction in liver transplantation, particularly when the vessels obtained from the donor are inadequate. We have used a composite graft of donor iliac artery and recipient inferior mesenteric vein (IMV) between the infrarenal aorta and donor hepatic artery. Postoperative liver function was satisfactory, with normal daily duplex ultrasound scans for the first 2 weeks. At 4 years follow up, graft function is normal, a duplex ultrasound scan shows normal arterial flow and no dilatation of the composite graft, and a magnetic resonance angiogram reveals no evidence of dilatation or thrombosis of the composite graft. This is one of the few reported cases in which a composite graft has been used to arterialize the allograft in liver transplantation. A composite graft of iliac artery and IMV provided a satisfactory outcome in this patient and may be a valuable addition to the arterial grafts available to the liver transplant surgeon.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/5. Acute acalculous cholecystitis due to an incarcerated epigastric hernia.A case of a 96 year old woman with an incarcerated gallbladder in an epigastric hernia causing acute acalculous cholecystitis is described. At operation the gallbladder was replaced in its anatomical site and the hernia was repaired. This unique case of acute acalculous cholecystitis demonstrates cystic duct obstruction and cystic vessel compression as possible aetiologies for this pathology.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/5. Surgical complications of Kawasaki disease.Four of 10 cases of Kawasaki disease (KD), mucocutaneous lymph node syndrome, seen from 1975 to 1980 had serious surgical complications. These included gallbladder obstruction, massive necrosis of gallbladder, liver, duodenum, jejunum, and necrosis of digits of both hands. Less serious necrosis of adrenals, testes, bladder, and stomach were seen. The operative mortality rate was 25%. The etiology is unknown. The average age was 2 yr. There was no sex preponderance. The essential lesion is an arteritis and periarteritis initially involving small arteries and later the medium and large vessels.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/5. Idiopathic perforation of the gallbladder: report of a case and a review of the Japanese literature.A 79-year-old man was admitted to our hospital because of severe epigastric pain. ultrasonography and computed tomography revealed a slightly distended gallbladder with a small amount of free intraabdominal fluid. At emergency laparotomy, perforation of the gallbladder was recognized and thus a cholecystectomy was performed. Histopathologically, localized necrosis was seen at the site of perforation: however, the inflammation of the surrounding tissue was mild and no thrombus was detected within the intramural vessels. In addition, the gallbladder contained no stones and a bile culture was negative. Postoperatively, the diagnosis of idiopathic perforation of the gallbladder was established. The findings of this case help to emphasize the importance of considering this disorder in elderly patients presenting with peritonitis of unknown origin.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |