Pseudoaneurysms are a rare and potentially life-threatening complication that can be caused by trauma, infections, tumors, autoimmune diseases, organ transplants, or idiopathic causes. The management of liver trauma is based on the anatomy of the injury and the patient's physiology. Posttraumatic hepatic artery pseudoaneurysm (HAP) is a life-threatening complication that requires prompt recognition and a multidisciplinary approach in its management. We present a case of HAP rupture two weeks following a gunshot wound to the liver.
A 53-year-old mentally retarded male was brought to our emergency room after vomiting a plastic glove. Computed tomography revealed marked gastric distention containing large amount of residual food debris. Endoscopic retrieval was unsuccessful. Surgical removal of the foreign bodies was done. The patient did well and was discharged from the hospital.
Meckel's diverticulum is the most common congenital anomaly of the small intestine. It is a true diverticulum containing all layers of the intestinal wall and results from the incomplete resolution of the omphalomesenteric duct. The majority of the cases are asymptomatic; however, diagnostic challenges arise when it becomes inflamed, causes gastrointestinal hemorrhage, intestinal obstruction, or when it protrudes through a potential abdominal opening (Littre's hernia). We present a rare case of strangulated Meckel's diverticulum as a result of axial torsion presenting with right lower quadrant abdominal pain.
chloride, Y-shaped bypass tubes were created with venous cannulas on each end. Heparinized saline filled the tubing and 30 U/kg of systemic heparin administered. The left internal jugular (IJ) vein was cannulated with the single arm of the Y. The portal vein (PV) was cannulated with one of the double arms, then divided. Clamps were removed to establish PV-IJ flow. Infra-hepatic inferior vena cava (IVC) was then cannulated, divided and flow established. Cannulas were secured with Rumel tourniquets and additionally secured to the tubing. Suprahepatic IVC was clamped and liver was removed. The suprahepatic IVC anastomosis was completed, then the PV and infrahepatic IVC anastomoses. Bypass time, flow, and one-hour post-reperfusion pH were recorded. Results: Eleven liver transplants were performed from eleven donor pigs. Mean weight of the donor and recipient animals was 23.5 kg +/-4.1 and 29.2 kg +/-6.4, respectively. There were two peri-operative mortalities: one pig died due to portal bypass cannula dislocation and the other due to inadequate ventilation. Of the 9 animals successfully transplanted with the use of passive veno-venous bypass, all survived until sacrifice. The mean time on bypass was 52 minutes +/-15.5. The mean flow (L/min) at 10, 20, and 30 minutes on bypass was 0.55 +/-0.06, 0.54 +/-0.06, and 0.33 +/-0.25. The mean pH at 1-hour post-reperfusion was 7.4 +/-0.17. The cost per set up was approximately 112 USD. Conclusion: This series of experimental orthotopic liver transplantation in pigs shows that the use of passive venovenous bypass with heparin-bonded polyvinyl chloride tubing to maintain hemodynamic stability during the recipient hepatectomy, is a less expensive alternative compared to bypass with a centrifugal pump.
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.