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Pencovich N, Younis M, Lessing Y, Zac L, Lessing JB, Yogev Y, Kupferminc MJ, Nachmany I. Major liver resection in pregnancy: three cases with different etiologies and review of the literature. J Matern Fetal Neonatal Med 2017; 32:203-211. [DOI: 10.1080/14767058.2017.1376315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Niv Pencovich
- Department of Surgery, The Nikolas & Elizabeth Shlezak Fund for Experimental Surgery, Tel Aviv, Israel
| | - Muhammad Younis
- Department of Surgery, The Nikolas & Elizabeth Shlezak Fund for Experimental Surgery, Tel Aviv, Israel
| | - Yonatan Lessing
- Department of Surgery, The Nikolas & Elizabeth Shlezak Fund for Experimental Surgery, Tel Aviv, Israel
| | - Lilach Zac
- Division of Anesthesiology, Pain, and Intensive Care, Tel Aviv, Israel
| | - Joseph B. Lessing
- Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Michael J. Kupferminc
- Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ido Nachmany
- Department of Surgery, The Nikolas & Elizabeth Shlezak Fund for Experimental Surgery, Tel Aviv, Israel
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Severe spontaneous hemoperitoneum in pregnancy may be linked to in vitro fertilization in patients with endometriosis: a systematic review. Fertil Steril 2016; 106:692-703. [DOI: 10.1016/j.fertnstert.2016.05.025] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 05/17/2016] [Accepted: 05/17/2016] [Indexed: 12/14/2022]
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Donati M, Stavrou GA, Donati A, Oldhafer KJ. The risk of spontaneous rupture of liver hemangiomas: a critical review of the literature. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2016; 18:797-805. [PMID: 21796406 DOI: 10.1007/s00534-011-0420-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The risk of spontaneous bleeding or rupture of liver hemangiomas still remains unknown. The aim of this review was to analyze the problem of spontaneous bleeding or rupture in liver hemangiomas and to identify factors leading to bleeding in these cases. METHODS A MEDLINE search was undertaken to identify articles in English, French, German, Italian, and Spanish from 1898 to 2010. Basic data such as age and sex of patients were collected. Additional data such as risk factors or causes of rupture were also analyzed. Cases were divided into spontaneous and non-spontaneous ruptures. RESULTS A total of 97 cases are described. In 51 of the 97 patients (52.6%) a non-spontaneous rupture was identified. Only in 46 out of the 97 cases (47.4%) was a spontaneous rupture found. Non-spontaneous rupture was significantly more frequent in patients aged <40 years than in older ones (p = 0.0099). Mean size of the ruptured lesions was 11.2 cm (range 1-37 cm). Massive bleeding occurred in 88 patients (90.7%). Reported mortality over the past 20 years has been significantly lower than before (p < 0.001). The overall mortality for the period under study was ~35%. CONCLUSIONS The spontaneous rupture of a hepatic hemangioma is to be considered an exceptional event. Preventive surgery should be considered only for lesions of at least 11-cm size in special cohorts of patients.
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Affiliation(s)
- Marcello Donati
- Department of General and Abdominal Surgery, Asklepios Hospital Barmbek, Asklepios Medical School, Rübenkamp 220, Hamburg, Germany.
- Department of Surgical Science, Organ Transplants and New Technologies, General Surgery and Week Hospital, University Hospital of Catania, Catania, Italy.
| | - Gregor A Stavrou
- Department of General and Abdominal Surgery, Asklepios Hospital Barmbek, Asklepios Medical School, Rübenkamp 220, Hamburg, Germany
| | - Angelo Donati
- Department of Surgical Science, Organ Transplants and New Technologies, General Surgery and Week Hospital, University Hospital of Catania, Catania, Italy
| | - Karl J Oldhafer
- Department of General and Abdominal Surgery, Asklepios Hospital Barmbek, Asklepios Medical School, Rübenkamp 220, Hamburg, Germany
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Toro A, Mahfouz AE, Ardiri A, Malaguarnera M, Malaguarnera G, Loria F, Bertino G, Di Carlo I. What is changing in indications and treatment of hepatic hemangiomas. A review. Ann Hepatol 2014. [PMID: 24927603 DOI: 10.1016/s1665-2681(19)30839-7] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Hepatic cavernous hemangioma accounts for 73% of all benign liver tumors with a frequency of 0.4-7.3% at autopsy and is the second most common tumor seen in the liver after metastases. Patients affected by hemangioma usually have their tumor diagnosed by ultrasound abdominal examination for a not well defined pain, but pain persist after treatment of the hemangioma. The causes of pain can be various gastrointestinal pathologies including cholelithiasis and peptic ulcer disease.The malignant trasformation is practically inexistent. Different imaging modalities are used to diagnosis liver hemangioma including ultrasonography, computed tomography (CT), magnetic resonance (MR) imaging, and less frequently scintigraphy, positronemission tomography combined with CT (PET/CT) and angiography. Imaging-guided biopsy of hemangioma is usually not resorted to except in extremely atypical cases. The right indications for surgery remain rupture, intratumoral bleeding, Kasabach-Merritt syndrome and organ or vessels compression (gastric outlet obstruction, Budd-Chiari syndrome, etc.) represents the valid indication for surgery and at the same time they are all complications of the tumor itself. The size of the tumor do not represent a valid indication for treatment. Liver hemangiomas, when indication exist, have to be treated firstly by surgery (hepatic resection or enucleation, open, laproscopic or robotic), but in the recent years other therapies like liver transplantation, radiofrequency ablation, radiotherapy, trans-arterial embolization, and chemotherapy have been applied.
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Affiliation(s)
- Adriana Toro
- Department of Surgery, Taormina Hospital, Messina, Italy
| | | | - Annalisa Ardiri
- Hepatology Unit. Department of Medical and Pediatric Science, University of Catania, Italy
| | | | - Giulia Malaguarnera
- University of Catania; Research Center "The Great Senescence". Cannizzaro Hospital, Italy
| | | | - Gaetano Bertino
- Hepatology Unit. Department of Medical and Pediatric Science, University of Catania, Italy
| | - Isidoro Di Carlo
- Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania. Catania, Italy; Department of Radiology, Hamad General Hospital, Doha Qatar
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5
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Giulini S, Zanin R, Volpe A. Hemoperitoneum in pregnancy from a ruptured varix of broad ligament. Arch Gynecol Obstet 2010; 282:459-61. [DOI: 10.1007/s00404-010-1411-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2009] [Accepted: 02/15/2010] [Indexed: 10/19/2022]
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6
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Spontaneous haemoperitoneum after the second trimester of pregnancy. Diagnosis and management. Eur J Obstet Gynecol Reprod Biol 2008; 142:82-3. [PMID: 18990480 DOI: 10.1016/j.ejogrb.2008.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Revised: 06/05/2008] [Accepted: 09/04/2008] [Indexed: 11/22/2022]
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7
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Jeanty C, Ismail L, Turner CD. Incidental Findings During Routine Antepartum Obstetrical Sonography. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2008. [DOI: 10.1177/8756479308325465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The standard for performing an antepartum obstetrical sonogram primarily involves the examination of the fetus; however, both the American Institute of Ultrasound in Medicine (AIUM) and American College of Radiology (ACR) guidelines suggest the evaluation of maternal structures as well. The authors present 35 incidental findings that were discovered on routine antepartum obstetrical sonography. These include abdominal wall, gastrointestinal, reproductive, urinary, and vascular anomalies in the maternal structures. A review of the literature demonstrates that many of these findings have clinical significance, which highlights the wisdom of the AIUM and ACR guidelines, and it also stresses the importance of seeking and reporting them.
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Affiliation(s)
- Cerine Jeanty
- Wayne State University, School of Medicine, Detroit, Michigan
| | - Lana Ismail
- Wayne State University, School of Medicine, Detroit, Michigan
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Mortele KJ, Cantisani V, Brown DL, Ros PR. Spontaneous intraperitoneal hemorrhage: imaging features. Radiol Clin North Am 2004; 41:1183-201. [PMID: 14661665 DOI: 10.1016/s0033-8389(03)00118-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Spontaneous intraperitoneal bleeding can result from a vast array of etiologies. Fortunately, most are uncommon and currently available imaging modalities can be used to differentiate them in almost all cases. Meticulous imaging technique and careful observation of key imaging features are important for accurate characterization of the organ of origin of the spontaneous bleeding. CT is the single most important imaging technique in the detection and characterization of spontaneous intraperitoneal bleeding. Further development in multidetector technology, such as the introduction of new machines with 8 or 16 detectors, should improve the effectiveness of CT further. Sonography and MR imaging are complimentary to CT, especially in patients with pelvic abnormalities or equivocal CT findings.
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Affiliation(s)
- Koenraad J Mortele
- Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
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Abstract
Numerous medical, surgical, psychiatric, gynecologic, and obstetric disorders can cause abdominal pain during pregnancy. The patient history, physical examination, laboratory data, and radiologic findings usually provide the diagnosis. The pregnant woman has physiologic alterations that affect the clinical presentation, including atypical normative laboratory values. Abdominal ultrasound is generally the recommended radiologic imaging modality; roentgenograms are generally contraindicated during pregnancy because of radiation teratogenicity. Concerns about the fetus limit the pharmacotherapy. Maternal and fetal survival have recently increased in many life-threatening conditions, such as ectopic pregnancy, appendicitis, and eclampsia, because of improved diagnostic technology, better maternal and fetal monitoring, improved laparoscopic technology, and earlier therapy.
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Affiliation(s)
- Mitchell S Cappell
- Division of Gastroenterology, Department of Medicine, Woodhull Medical Center, 760 Broadway Avenue, Brooklyn, NY 11206, USA
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Chen ZY, Qi QH, Dong ZL. Etiology and management of hemmorrhage in spontaneous liver rupture: a report of 70 cases. World J Gastroenterol 2002; 8:1063-6. [PMID: 12439926 PMCID: PMC4656381 DOI: 10.3748/wjg.v8.i6.1063] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To analyze the causes and management of hemorrhage in spontaneous liver rupture.
METHODS: Seventy cases of spontaneous liver rupture were retrospectively analyzed for causes of hemorrhage and therapeutic effects of surgical approaches.
RESULTS: It was demonstrated that the causes of spontaneous liver rupture were primary liver cancer in 60 cases (85.7%), cirrhosis in 3 cases (4.3%), liver angioma in 2 cases (2.9%), liver adenoma in 4 cases (5.7%),and secondary liver cancer in 1 case (1.4%). Hemostasis was achieved with surgical approaches in 68 cases (97.1%) and non-surgical approaches in 2 cases (2.9%). Surgical interventions included suture, ligation of hepatic artery, hepatic artery chemoembolization and partial hepatic resection.
CONCLUSION: The results suggest that surgical intervention is still the main therapeutic method and the best procedure that should be selected according to causes of disease and patient’s condition and history.
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Affiliation(s)
- Zhe-Yu Chen
- Department of surgery, General Hospital of Tianjin Medical University, China
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