Liver Transplantation for Hemoperitoneum Secondary to Huge Multiple Hemangiomatosis: A Case Report of a Tele-intensive Care Unit in Deceased-Donor Management

Gruttadauria, Salvatore; Pagano, Domenico; Burgio, Gaetano; Panarello, Giovanna; Petridis, Ioannis; Cintorino, Davide; Spada, Marco; Vizzini, Giovanni

doi:10.1089/tmj.2014.0145

Cited by 3 publications

(2 citation statements)

References 11 publications

(12 reference statements)

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“…Other common symptoms included dyspnea and systemic symptoms of fevers and night sweats. Fatigue was also a reported symptom [17] . The most common finding on physical exam was hepatomegaly [19] , [20] , [21] reported in 8 of the 17 patients.…”

Section: Discussionmentioning

confidence: 99%

Isolated hepatic hemangiomatosis in 2 septuagenarians

Liu

Little

2018

Radiology Case Reports

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We report 2 cases of isolated hepatic hemangiomatosis: a 76-year-old woman who is, to our knowledge, the oldest person with this diagnosis, and a 74-year-old woman. Magnetic resonance imaging of the abdomen showed T2 hyper intense lesions throughout the liver, peripheral nodular arterial enhancement, and filling of contrast on the portal venous and delayed phases. Computed tomography showed liver lesions with peripheral nodular enhancement in the early phase and a centripetal pattern or “filling in” during the late phase; the lesions opacified after a delay of 3 or more minutes and remained isodense or hyperdense on delayed scans. Both images were consistent with hepatic hemangiomatosis. These cases help increase awareness about benign and unusual liver lesions with radiologic characteristics similar to those of malignant liver tumors. The authors also present a review of 15 other cases of isolated hepatic hemangiomatosis reported in English literature from 1970 to present.

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Section: Discussionmentioning

confidence: 99%

Isolated hepatic hemangiomatosis in 2 septuagenarians

Liu

Little

2018

Radiology Case Reports

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“…20 Transplantation practice has already reported the use of tele-anesthesia with remote monitoring of difficult cases by an experienced transplant team. 21 The COVID-19 pandemic has changed the how we manage our ICUs with virtual rounds, remote monitoring of vital signs and collaboration across specialties in the COVID care unit and emergency surgical workflows. 22,23…”

Section: Introductionmentioning

confidence: 99%

Point-of-Care Echocardiography and Hemodynamic Monitoring in Cirrhosis and Acute-on-Chronic Liver Failure in the COVID-19 Era

Premkumar

Kajal

Kulkarni

et al. 2021

J Intensive Care Med

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Point-of-Care (POC) transthoracic echocardiography (TTE) is transforming the management of patients with cirrhosis presenting with septic shock, acute kidney injury, hepatorenal syndrome and acute-on-chronic liver failure (ACLF) by correctly assessing the hemodynamic and volume status at the bedside using combined echocardiography and POC ultrasound (POCUS). When POC TTE is performed by the hepatologist or intensivist in the intensive care unit (ICU), and interpreted remotely by a cardiologist, it can rule out cardiovascular conditions that may be contributing to undifferentiated shock, such as diastolic dysfunction, myocardial infarction, myocarditis, regional wall motion abnormalities and pulmonary embolism. The COVID-19 pandemic has led to a delay in seeking medical treatment, reduced invasive interventions and deferment in referrals leading to “collateral damage” in critically ill patients with liver disease. Thus, the use of telemedicine in the ICU (Tele-ICU) has integrated cardiology, intensive care, and hepatology practices across the spectrum of ICU, operating room, and transplant healthcare. Telecardiology tools have improved bedside diagnosis when introduced as part of COVID-19 care by remote supervision and interpretation of POCUS and echocardiographic data. In this review, we present the contemporary approach of using POC echocardiography and offer a practical guide for primary care hepatologists and gastroenterologists for cardiac assessment in critically ill patients with cirrhosis and ACLF. Evidenced based use of Tele-ICU can prevent delay in cardiac diagnosis, optimize safe use of expert resources and ensure timely care in the setting of critically ill cirrhosis, ACLF and liver transplantation in the COVID-19 era.

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