Interventional radiologist Josef Rösch is recognized as the creator of the transjugular intrahepatic portosystemic shunt (TIPS) procedure. In 1969, while performing transjugular cholangiography, he inadvertently initiated the approach. 1 Transjugular cholangiography is a procedure in which a catheter is introduced into the jugular vein and advanced through the superior vena cava, to the right atrium, and directed into the hepatic vein. Using the catheter, a needle is then introduced through the hepatic vein, into the liver, and passed into the bile ducts. The goal is to administer contrast into the biliary system to evaluate patency. This method was believed to be safer for the patient than puncturing the liver capsule because patients often experienced bleeding, ascites, and obstructive jaundice with the percutaneous liver technique. According to Rösch, 1 the procedure often experienced technical difficulties, and the needle would mistakenly puncture into the portal vein. The idea of shunting the portal system was developed and is currently used to treat portal hypertension, ascites, and variceal hemorrhage. 2 Anatomy and Physiology Normal liver vascularity includes the portal vein transporting blood into the liver from the bowel along with inflow from the hepatic artery. The hepatic veins drain the liver and transport blood into the inferior vena cava. The portal vein is responsible for supplying about two-thirds of the blood flow volume into the liver. 3 In the diseased liver, blood flow into the liver is often compromised due to fibrotic changes within the liver's parenchyma. The resistance to the movement of blood into the liver increases, which then increases the portal flow resistance. Over a period of time, the portal circulation is altered, and portal hypertension occurs. The resulting effects are debilitating and progressive. Portal hypertension creates a process where blood is shunted away from the liver. This blood is forced into small, thin vessels connected to veins in the esophagus, stomach, and rectal areas. 4 These thin, dilated vessels are called varices, and they often weaken and hemorrhage. Up to 50% of patients with cirrhosis will eventually form esophageal varices. 5 746338J DMXXX10.
Alcoholic liver disease (ALD), a precursor to alcohol-induced cirrhosis, is a disease caused by excessive ingestion of alcoholic substances that directly affects liver functions. Abnormal liver function can cause the liver to damage other organs within the abdomen. This case study examines the physiological nature of alcohol-induced cirrhosis and its pathogenesis, external and internal clinical presentations, and treatment options. Treatments for alcohol-induced cirrhosis include liver transplant for permanent correction as well as varied options to manage symptoms. This case study analyzes alcoholic liver disease within one male patient whose condition highlights the importance of sonography in routinely monitoring patients with ALD.
Congenital diaphragmatic hernia (CDH) is an opening in the diaphragm in which the abdominal viscera protrudes into the chest as the result of an embryologic defect. CDH can be an isolated anomaly or occur simultaneously with a chromosomal abnormality or genetic syndrome. Prognosis for fetuses with CDH is widely variable and depends on numerous factors including premature birth, the presence of a chromosomal abnormality or genetic disorder, location of the herniation, lung volume, and cardiac involvement. This study presents details of a case of right-sided CDH with an intrathoracic kidney detected sonographically. Fetal echocardiography and magnetic resonance imaging (MRI) were used to further characterize the herniation. Both sonography and MRI aided in accurate diagnosis and postnatal treatment planning.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.