Sonographic findings in noncirrhotic portal fibrosis

Gürkaynak, Gönül; Yıldırım, Bülent; Aksoy, Fehmi; Temuçin, Gülay

doi:10.1002/(sici)1097-0096(199807/08)26:6<309::aid-jcu5>3.0.co;2-m

Cited by 8 publications

(6 citation statements)

References 19 publications

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“…Similarly, non-cirrhotic portal fibrosis, which is often reported from the Asian subcontinent, may occasionally mimic the ultrasonographic image patterns of mild-moderate schistosomal PPT/F. 46 Although this possibility cannot be excluded with absolute certainty, none of our patients presented with the typical clinical and ultrasonographic features of non-cirrhotic PPT/F, 47 thus making it an unlikely cause of PPT/F in our study community.…”

Section: Discussionmentioning

confidence: 61%

Intensity of Schistosoma Mansoni, Hepatitis B, Age, and Sex Predict Levels of Hepatic Periportal Thickening/Fibrosis (PPT/F): A Large-Scale Community-Based Study in Ethiopia

Berhe

Myrvang²,

Gundersen³

2007

Am J Trop Med Hyg

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To elucidate determinants of morbidity in schistosomiasis mansoni, a community-based study was undertaken involving 2,451 subjects (mean age, 18.8 ± 15.3 [SD] years) from four endemic sites in Ethiopia. Overall prevalence of infection was 65.9%, reported blood in stools was 35.8%, and schistosomal periportal thickening/fibrosis (PPT/F) was 4.6%. Similarly, 43.2% were positive for at least one marker of hepatitis B virus (HBV), 5.3% were HBsAg positive, and 1.3% were anti-hepatitis C virus (HCV) positive. Prevalence of PPT/F increased significantly with increasing community prevalence and intensity of S. mansoni infection. In a multiple logistic regression analysis, intensity of egg excretion, markers of HBV infection, age, and male sex were significantly associated with PPT/F, whereas co-infection with other intestinal helminths was associated with lower odds for PPT/F. HCV was not associated with S. mansoni infection or with schistosomal PPT/F. In conclusion, integrated helminth control targeting school-aged children, who have the highest burden infection, should be used to substantially reduce the risk of periportal fibrosis.

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Section: Discussionmentioning

confidence: 61%

Intensity of Schistosoma Mansoni, Hepatitis B, Age, and Sex Predict Levels of Hepatic Periportal Thickening/Fibrosis (PPT/F): A Large-Scale Community-Based Study in Ethiopia

Berhe

Myrvang²,

Gundersen³

2007

Am J Trop Med Hyg

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“…The dominant histological abnormality was a prominent fibrous thickening around the portal vein and its branches. 41 A case study reported the presence of well demarcated bands of increased echogenicity surrounding the portal tracts. Subsequent postmortem examination revealed several large and medium sized portal tracts in both liver lobes with an increased fibrous connective tissue.…”

Section: Discussionmentioning

confidence: 99%

Periportal fibrosis and other liver ultrasonography findings in vinyl chloride workers

Maroni

Mocci²,

Visentin³

et al. 2003

Occup Environ Med

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Aims: To investigate the presence of liver lesions and their relation with vinyl chloride monomer (VCM) exposure or other personal risk factors, in workers involved in the production of VCM and polyvinyl chloride (PVC). Methods: A liver ultrasonography examination was conducted in 757 workers, some of whom had long standing service in the production of VCM and PVC. The study involved: assessment of individual past and present VCM exposure of each worker; collection of past personal health history, lifestyle and personal data; routine liver function tests; and liver ultrasonography. Results: No cases of liver malignancies were detected. Angiomas and liver cysts were found with a frequency of occurrence within the expected range of the general population. The main findings consisted of hepatomegaly (34.7%), steatosis (31.8%), and periportal fibrosis (16.0%). A logistic regression analysis indicated that hepatomegaly and steatosis were associated with obesity and lipid metabolism disturbances and not with VCM exposure. Periportal fibrosis, in addition to constitutional or dietary factors, was shown to be associated with VCM exposure, but only when maximum exposure in the subject's history had been at least 200 ppm as a yearly average; no effects were observed at 50 ppm or below. Conclusions: Workers exposed to 200 ppm VCM for at least one year have a fourfold increased risk of developing periportal liver fibrosis. Liver ultrasonography is a suitable and important diagnostic test for the medical surveillance of vinyl chloride workers.T he production of vinyl chloride monomer (VCM) and polyvinyl chloride (PVC) started in Italy in the 1950s and 1960s in six chemical plants, four of which were still in operation in the year 2000. Mortality studies conducted on workers employed in these plants, indicated an increased incidence of liver angiosarcoma, while the presence of other liver lesions and other types of cancer was unclear. [1][2][3][4] After the recognition of the carcinogenicity of VCM in the early 1970s, measures were adopted in the plants to decrease VCM exposure and monitor the occupational exposure levels of the workers. From levels of air concentrations of hundreds of ppm, common in the 1960s and 1970s, the VCM concentrations in the manufacturing plants were reduced to a few ppm in the 1980s and, more recently, to values below 1 ppm.The workforce currently employed in VCM/PVC production includes workers with a long standing service in these plants; some of these workers worked in the plants when high levels of VCM exposure were common. Although all VCM and PVC production workers in Italy are medically examined with a battery of liver tests twice a year, this medical surveillance has a limited diagnostic power for the identification of focal or diffuse lesions of the liver. Thus a liver ultrasonography examination was carried out to detect the presence of hidden liver lesions and to investigate their relation with VCM exposure or other personal risk factors.This paper describes and analyses the results of thi...

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“…Similarly, no relation was seen between ultrasonographic increased portal echogenicity, the existence of ascites, and the histological findings of periportal fibrosis. 23 Although the relatively small size of our sample limits our ability to make decisive conclusions, we think that longstanding cyanosis in patients with congenital heart disease is a risk factor for liver periportal fibrosis. Larger scale investigations and longitudinal studies should be undertaken to confirm our findings.…”

Section: Discussionmentioning

confidence: 94%

Ascites in Adult Patients With Cyanotic Congenital Heart Disease

Martínez‐Quintana

Rodríguez‐González

Cabrera-Pérez

et al. 2010

World J Pediatr Congenit Heart Surg

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Hematologic, neurologic, renal, and rheumatic complications in patients with cyanotic congenital heart disease are well known. However, the effects of this condition on the liver are poorly described. Between April 2005 and April 2010, 25 adults with cyanotic congenital heart disease were studied to determine clinical history, liver ultrasonographic data, and liver histological presentation. Twenty-five patients, with a median age of 28.7 ± 8.3 years and a basal tissue hemoglobin oxygen saturation of 83.3% ± 6.8%, were studied. Liver ultrasonographic examination showed abnormalities in 10 of 20 patients (50%): 6 patients (30%) had hepatomegaly, 2 patients (10%) heterogeneous parenchyma echo pattern, and 2 patients (10%) increased portal echogenicity. Ascites was found in 7 patients (28%): 4 patients had refractory ascites and 3 patients anasarca. Patients with anasarca responded well to oral and intravenous furosemide, but those with isolated ascites did not. No data to indicate severe ventricular dysfunction or severe valve regurgitation were seen. In patients with refractory ascites who had therapeutic paracentesis, serum-ascites albumin gradient in ascites was greater than 1.1 g/dL. No significant association was found between patients with or without ascites when laboratory data and New York Heart Association functional class were compared. Liver biopsy was performed in 6 patients (24%). The most remarkable liver histological finding, in those with refractory ascites, was the existence of periportal fibrosis associated with sinusoidal dilatation. Periportal liver fibrosis associated with congestive heart failure, sepsis, or a long-term Fontan procedure can trigger refractory ascites formation.

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Sonographic findings in noncirrhotic portal fibrosis

Cited by 8 publications

References 19 publications

Intensity of Schistosoma Mansoni, Hepatitis B, Age, and Sex Predict Levels of Hepatic Periportal Thickening/Fibrosis (PPT/F): A Large-Scale Community-Based Study in Ethiopia

Intensity of Schistosoma Mansoni, Hepatitis B, Age, and Sex Predict Levels of Hepatic Periportal Thickening/Fibrosis (PPT/F): A Large-Scale Community-Based Study in Ethiopia

Periportal fibrosis and other liver ultrasonography findings in vinyl chloride workers

Ascites in Adult Patients With Cyanotic Congenital Heart Disease

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