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1.
Sci Rep ; 10(1): 19612, 2020 11 12.
Artículo en Inglés | MEDLINE | ID: mdl-33184342

RESUMEN

Massive hepatic necrosis after therapeutic embolization has been reported. We employed a 320-detector CT scanner to compare liver perfusion differences between blunt liver trauma patients treated with embolization and observation. This prospective study with informed consent was approved by institution review board. From January 2013 to December 2016, we enrolled 16 major liver trauma patients (6 women, 10 men; mean age 34.9 ± 12.8 years) who fulfilled inclusion criteria. Liver CT perfusion parameters were calculated by a two-input maximum slope model. Of 16 patients, 9 received embolization and 7 received observation. Among 9 patients of embolization group, their arterial perfusion (78.1 ± 69.3 versus 163.1 ± 134.3 mL/min/100 mL, p = 0.011) and portal venous perfusion (74.4 ± 53.0 versus 160.9 ± 140.8 mL/min/100 mL, p = 0.008) were significantly lower at traumatic parenchyma than at non-traumatic parenchyma. Among 7 patients of observation group, only portal venous perfusion was significantly lower at traumatic parenchyma than non-traumatic parenchyma (132.1 ± 127.1 vs. 231.1 ± 174.4 mL/min/100 mL, p = 0.018). The perfusion index between groups did not differ. None had massive hepatic necrosis. They were not different in age, injury severity score and injury grades. Therefore, reduction of both arterial and portal venous perfusion can occur when therapeutic embolization was performed in preexisting major liver trauma, but hepatic perfusion index may not be compromised.


Asunto(s)
Embolización Terapéutica/métodos , Hígado/diagnóstico por imagen , Hígado/lesiones , Imagen de Perfusión/métodos , Heridas no Penetrantes/diagnóstico por imagen , Heridas no Penetrantes/terapia , Adulto , Embolización Terapéutica/efectos adversos , Femenino , Arteria Hepática , Humanos , Masculino , Necrosis Hepática Masiva/diagnóstico por imagen , Necrosis Hepática Masiva/etiología , Persona de Mediana Edad , Perfusión , Vena Porta , Estudios Prospectivos , Tomografía Computarizada por Rayos X , Adulto Joven
4.
Acta Cardiol ; 64(1): 95-7, 2009 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19317305

RESUMEN

A 60-year-old man without any history of cardiac disease was admitted for fulminant hepatic failure (FHF) with coma which revealed severe dilated cardiomyopathy. The patient improved with an adapted medical treatment and was finally discharged from the hospital. Congestive heart failure is a rare cause of FHF, but an important differential diagnosis because it has a specific and potentially efficient treatment.


Asunto(s)
Cardiomiopatía Dilatada/complicaciones , Coma/etiología , Necrosis Hepática Masiva/etiología , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Aspirina/uso terapéutico , Cardiomiopatía Dilatada/diagnóstico por imagen , Diagnóstico Diferencial , Diuréticos/uso terapéutico , Humanos , Masculino , Necrosis Hepática Masiva/diagnóstico por imagen , Persona de Mediana Edad , Inhibidores de Agregación Plaquetaria/uso terapéutico , Factores de Riesgo , Ultrasonografía
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