Pancreatic pseudocyst located in the liver: a case report and literature review.

Pancreatic pseudocyst in the liver is a rare complication of acute or chronic pancreatitis. However, its frequency seems to be increasing with modem imaging procedures. The authors report a case of pancreatic pseudocyst involving the left lobe of the liver that occurred in a patient who never showed clinical evidence of pancreatitis or pancreatic injury. Complete screening led to the discovery of alcoholic chronic pancreatitis. The pseudocyst was treated successfully by radiologic drainage. The pancreatic pseudocyst location and therapeutic approaches are discussed. A literature review uncovered 26 cases of hepatic pancreatic pseudocysts. Clinical presentation, imaging characteristics, and treatment of these cases are analyzed.

[Hepatitis B: epidemiology, natural history, biology, treatment monitoring]. / Hépatite B: épidémiologie, histoire naturelle, biologie, surveillance du traitement.

Hepatitis B virus (HBV) infection is a worldwide public health problem. In France, 150,000 individuals are infected with the HBV. Although many are asymptomatic carriers, about 30% have chronic hepatitis, a condition associated with a risk of cirrhosis and hepatocellular carcinoma. Antiviral treatments, most notably interferon alpha, probably modify the natural history of hepatitis B, decreasing the risk of hepatocellular carcinoma and increasing survival. Nucleoside analogs, particularly lamivudine, have also demonstrated potent antiviral activity, which should however be weighed against the increasing risk over time of mutation development in the YMDD region of the DNA polymerase reverse transcriptase. Antiviral therapy monitoring should include clinical safety evaluations and periodic laboratory tests including blood cell counts, transaminase activities, and serum DNA levels. The improving results provided by antiviral drugs should not deflect attention away from the importance of large-scale hepatitis B immunization of neonates, which has been shown to decrease the incidence of hepatocellular carcinoma in areas with high levels of hepatitis B endemicity.

Marked increase in serum CA 19-9 level in patients with alcoholic cirrhosis: report of four cases.

We report four cases of marked increase in serum carbohydrate antigen (CA 19-9) levels in patients with severe alcoholic cirrhosis without any evidence of gastric or pancreatic carcinoma. Brief reports were obtained from two hepatology units of four cirrhotic patients, three of them with alcoholic hepatitis. In the four cases, improvement of liver function and disappearance of jaundice were associated with a decrease to normal serum CA 19-9 levels. These observations show that a marked increase in serum CA 19-9 level in patients with severe hepatic dysfunction is not diagnostic of pancreatic or gastric carcinoma.