Visible Liver from Huge Gastric Penetration

Matsuzaka, Suguru; Nagai, Yuki; Hoshi, Tetsuya; Serizawa, Yoritomo

doi:10.2169/internalmedicine.0082-17

Cited by 2 publications

(2 citation statements)

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“…Among them, the most frequently observed presentation was peptic hepatitis (hepatocyte with a surrounding inflammatory reaction), which was found in nine cases, 10 , 13 , 18 , 22 , 25 , 28 , 31 , 35 , 37 and two cases did not have any apparent inflammation 9 , 14 and no information of inflammation was mentioned in five cases. 7 , 19 , 20 , 32 , 36 In the first article that described the features of peptic hepatitis, atypical hepatocytes were demonstrated. 10 Other changes in the liver tissue at the site of perforation were reported, which included macro–microvesicular degeneration, pseudoaciner transformation and perisinusoidal fibrosis, 15 and fibrotic granulation tissue.…”

Section: Resultsmentioning

confidence: 99%

Liver Involvement by Perforated Peptic Ulcer: A Systematic Review

Jiao¹,

Zhang²

2021

Journal of Clinical and Translational Pathology

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Background and Objective: Liver penetration by a confined perforation of peptic ulcer is a rare but severe event. Its clinical and pathological features are unclear. Methods: In total, 41 qualified English publications were identified using the PubMed database and one in-house case. Results: Among the 42 patients, 20 patients had liver involvement by a perforated duodenal ulcer and 22 by a gastric ulcer. Among the 23 cases of known ulcer histology, 2 ulcers were malignant and were adenocarcinomas in the gastric remnant and the remaining 21 ulcers were confirmed as histologically benign (for frequency of malignancy in duodenal versus gastric ulcers, p = 0.48). The presence of hepatocytes was the clue of diagnosis for 19 cases. The median ages of the patients were 64.5 years (95% Confidence Intervals [CI] 53.40-71.90) for duodenal ulcer and 65.5 years (95% CI: 59.23-70.95) for gastric ulcer, respectively. The male to female ratio was 1.5:1 for duodenal ulcers and 2:1 for gastric ulcers. Patients with liver involvement of a perforated gastric ulcer were more likely to have a larger ulcer (median largest dimension, 4.75 cm versus 2.5 cm, p = 0.014). Female patients with liver involvement of a gastric ulcer were older than male patients (median age 72 versus 60 years, p = 0.045). There were no differences in gender, region (Asia, Europe, America versus others), use of nonsteroidal anti-inflammatory drugs (n = 15), H. Pylori positivity (n = 10), possible history of peptic ulcer disease (n = 19) or mortality (n = 32) between duodenal and gastric ulcers. Conclusions: Careful histologic examination, clinicopathological correlation, and immunohistochemistry are critical to establish the diagnosis and avoid misdiagnosing liver involvement as malignancy.

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Section: Resultsmentioning

confidence: 99%

Liver Involvement by Perforated Peptic Ulcer: A Systematic Review

Jiao¹,

Zhang²

2021

Journal of Clinical and Translational Pathology

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“…Gastric ulcer penetration into liver is a rare event, usually presenting with abdominal pain or gastrointestinal bleeding (1). The usual endoscopic appearance is a large gastric ulcer with deep fibrin-covered base and the diagnosis is usually established by biopsies (2).…”

Section: Dear Editormentioning

confidence: 99%