TAILIEUCHUNG - báo cáo khoa học: "Multiple infarcted regenerative nodules in liver cirrhosis after decompensation of cirrhosis: a case series"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Multiple infarcted regenerative nodules in liver cirrhosis after decompensation of cirrhosis: a case series | Scholtze et al. Journal of Medical Case Reports 2010 4 375 http content 4 1 375 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Multiple infarcted regenerative nodules in liver cirrhosis after decompensation of cirrhosis a case series Dieter Scholtze1 Tanja Reineke2 Beat Mullhaupt3 Christoph Gubler3 Abstract Introduction Liver cirrhosis is a common disease with many known complications. Cirrhosis represents a clinical spectrum ranging from asymptomatic liver disease to hepatic decompensation. Manifestations of hepatic decompensation include variceal bleeding ascites hepatic encephalopathy hepatorenal syndrome hepatopulmonary syndrome portopulmonary hypertension and hepatocellular carcinoma. There are reports about infarcted regenerative nodules in cirrhotic livers after gastrointestinal hemorrhage. Case presentation We report three Caucasian patients one female and two male patients ages 52 54 and 60 years with decompensated liver cirrhosis who showed newly infarcted regenerative nodules at necropsy. Two of them suffered from gastric variceal bleeding. Histopathology showed extensive infarction in all three cases. Hemorrhage and inflammatory changes were also observed around the infarcted regenerative nodules. Conclusion These patients showed focal liver lesions to be considered in the differential diagnosis of cirrhotic livers. Infarcted regenerative nodules may be underdiagnosed in patients with decompensation of cirrhosis. In order to differentiate these lesions from malignant tumors serial imaging seems to be helpful. However the main differential diagnosis should be an abscess. It is important to know the wide spectrum of image appearances of these lesions. Hypotension can lead to a reduction of portal and arterial liver flow. Since variceal bleeding or septic shock can induce hypotension - as observed in our patients - we conclude that this leads to infarction of such nodules. Introduction Liver cirrhosis is a common

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