Hepatic artery thrombosis is the most frequent vascular complication following orthotopic liver transplantation, and often results in biliary complications, early graft loss and death. Surgical revascularization and retransplantation are considered the mainstay of treatment. However, intraarterial endovascular therapy is an alternative that has shown low morbidity and mortality, thereby avoiding the need for retransplantation. We describe a case of orthotopic liver transplantation complicated with hepatic artery thrombosis that was successfully treated with endovascular therapy.

IntroductionSolitary ulcers in the colon are rare and infrequent; little over 200 cases have been reported in medical literature. We present a case of a patient presenting with a solitary colonic ulcer associated with NSAIDs intake, mimicking a malignant lesion. A review of the literature is also revised.Presentation of case68- year-old female patient with past history of nonsteroidal anti-inflammatory drugs (NSAID) intake for chronic pain, complaining of severe abdominal pain was admitted to our teaching hospital. The diagnosis of a low-grade dysplasia was made with colonoscopy and biopsy, a malignant lesion could not be ruled out. A laparoscopy right colectomy was performed without complications. The final diagnosis resulted in a solitary cecal ulcer.DiscussionThe majority of the cases of solitary colonic ulcers occur in the ascending colon, at the cecum, which has been attributed mostly to the intake of NSAIDs. There could be solitary colonic ulcers in other portions of the large intestine, caused by different etiologies: ischemia, inflammatory disease, sterocoraceus ulcers, ulcers caused by infections, among other more uncommon causes. The diagnosis is often made through a biopsy of the tissue during a colonoscopy, with either surgical or conservative care.ConclusionThe diagnosis of solitary cecal ulcer should be considered in patients presenting with RLQ abdominal pain and with history of NSAIDs consumption. Recognition of this diagnosis by surgeons, ruling out malignancies, understanding the morphologic features, and carefully taking the patient's history are essential for the diagnosis and treatment of this uncommon disease.

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Background: Since first laparoscopic liver surgery in 1992 indications has grown, techniques improved and experience gained. This approach has proven to be feasible and safe, however there are still some challenges to overcome. This study was designed to describe our single center experience in laparoscopic liver resection. Methods: We performed a single-center retrospective chart review. Demographic information, indications, operative details, and postoperative outcome data were analyzed. Results are expressed as mean AE standard deviation. Results: We analyzed 25 laparoscopic liver resections. No one had complications. The conversion rate was 16% (4 cases). The mean blood loss was 225 mL (80e 500 mL). Measures of surgery time procedure [165 min (80e240)] and hospital length of stay [4 days (2e6)] was obtained. Discussion: Laparoscopic liver procedures have increased every year however tumor location and its relationship with liver anatomy are determining factors in decision to perform a minimal invasive approach. Despite the absence of absolute indications some recommendations include solitary lesions smaller than 5 cm and peripheral location; emphasizing that an experienced surgeon in liver and laparoscopic surgery must perform them. Conclusions: In this study was observed faster recovery of the patients combining the proven benefits of laparoscopy approach such less blood loss, minor postoperative pain, fewer days of narcotics used and shorter hospital stay. In our experience this approach is a safe and viable option for benign and malignant disease without compromising oncologic principles in properly selected patients.

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