Unexplained huge liver infarction presenting as a tumor with bleeding: A case report

Wang, Fu-Hai; Yang, Ningning; Liu, Feng; Hu, Tian

doi:10.12998/wjcc.v8.i10.2016

Cited by 5 publications

(6 citation statements)

References 23 publications

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“…21,22 Systemic circulatory insufficiency can also reduce intrahepatic blood flow and contribute to the development of hepatic infarction. 23 Hepatic infarction can be caused by iatrogenic injury to the hepatic vessels (mainly the hepatic arteries), liver abscesses, [24][25][26] and can be secondary to shock, sepsis, anesthesia, or biliary tract disease. 5,6 Arteriosclerosis and vascular endothelial damage caused by diabetes and hypertension can also lead to vessel wall thickening and luminal narrowing.…”

Section: Discussionmentioning

confidence: 99%

Hypervirulent Klebsiella pneumoniae Mediated Hepatic Infarction Septic Shock After Rectal Cancer Surgery: A Case Report

Li,

Yang,

Zheng

et al. 2024

IDR

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The liver receives blood from both the hepatic artery and portal vein. Hepatic infarction is rare in clinical practice as both the hepatic artery and portal vein can supply blood to the liver. Here, we reported a case of a 75-year-old man who underwent radical laparoscopic surgery for rectal cancer and subsequently developed hepatic infarction. The patient experienced severe infection, as well as circulatory and respiratory failure on the third day after surgery. The patient presented with high fever, chest tightness, shortness of breath, decreased blood oxygen saturation and blood pressure. The leukocyte count decreased from 8.10 × 10^9/L to 1.75 × 10^9/L. Procalcitonin (PCT) levels increased from 1.02 ng/mL to 67.14 ng/mL, and eventually reaching levels over 200 ng/mL. Enhanced abdominal computed tomography (CT) confirmed the presence of hepatic infarction, but no thrombosis was observed in the hepatic artery or portal vein. Metagenomic next-generation sequencing (mNGS) identified hypervirulent Klebsiella pneumoniae (hvKp) in the patient's blood and ascites, one day earlier than the detection results using traditional culture methods. The patient was diagnosed with hepatic infarction combined with septic shock caused by hvKp. This case emphasizes that in the high-risk group of thrombosis, infection can trigger exacerbated hepatic infarction events, particularly in cases after surgical procedures. For severely ill patients with infectious diseases who are admitted to the ICU with worsening symptoms, it is important to collect appropriate samples and send them for pathogen detection using mNGS in a timely manner. This may aid in early intervention and improve clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Hypervirulent Klebsiella pneumoniae Mediated Hepatic Infarction Septic Shock After Rectal Cancer Surgery: A Case Report

Li,

Yang,

Zheng

et al. 2024

IDR

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“…Liver infarctions are therefore rare and usually occur when there is a simultaneous portal vein obstruction. Liver infarctions have been described in cases of iatrogenic injury during interventions, such as cholecystectomy, transarterial chemoembolization, and transjugular intrahepatic portosystemic shunt placement, but also in systemic diseases, such as eosinophilic granulomatosis with polyangiitis, antiphospholipid syndrome, systemic lupus erythematosus, and liver abscesses [2,8].…”

Section: Arterial Portal Venous and Venous Perfusion Disordermentioning

confidence: 99%

“…So sind Leberinfarkte u. A. bei iatrogener Verletzung im Rahmen von Interventionen wie Cholezystektomie, transarterieller Chemoembolisation, transjugulärer intrahepatisch portosystemischer Shunt-Anlage beschrieben, aber auch bei systemischen Erkrankungen wie der eosinophilen Granulomatose mit Polyangiitis, dem Antiphospholipid-Syndrom, bei systemischem Lupus erythematodes und bei Leberabszessen [2,8].…”

Section: Arterielle Portalvenöse Und Venöse Perfusionsstörungunclassified

Contrast-enhanced ultrasound of the liver: Vascular pathologies and interventions

Safai Zadeh,

Prosch,

Ba-Ssalamah

et al. 2024

Rofo

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Over the past two decades, contrast-enhanced ultrasound (CEUS) has been established as a method complementary to B-mode ultrasound and color Doppler sonography for diagnosing vascular liver pathologies and interventions.The objective of this review is to elucidate the application of CEUS in diagnosing vascular pathologies and interventional procedures.Considering the limitations of ultrasound, CEUS presents a similar alternative to other imaging modalities, such as computed tomography and magnetic resonance imaging, for evaluating vascular pathologies, guiding interventions, identifying complications, and assessing outcomes post intervention. Due to its widespread availability and the absence of radiation exposure, CEUS should be employed as a primary modality.

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“…The clinical symptoms of liver infarction are variable: right-sided upper abdominal discomfort, chest pain, fever, nausea and vomiting and liver laboratory elevations. Patients may also remain mild or asymptomatic [28,[33][34][35]. In rare cases, liver infarction precipitates acute liver failure with high mortality rates [34].…”

Section: Liver Infarctionmentioning

confidence: 99%

“…The localization of hepatic infarction is frequently described in the right hepatic lobe [28,33,36,39,45,49,60], but can also occur in the left hepatic lobe [48] and may be multifocal particularly in the peripheries of both lobes [43,49,55,61]. Localization to the caudate lobe has also been reported [62].…”

Section: Imagingmentioning

confidence: 99%

Comments and illustrations of the WFUMB CEUS liver guidelines: Rare vascular pathology, part II

et al. 2023

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In this second part of the topic the hepatic pseudoaneurysm, hepatic infarction, and pylephlebitis are discussed as acute and potentially life-threatening hepatic vascular diseases. The focus is on their appearance on B-mode ultrasonography, duplex ultrasonography, and contrast-enhanced ultrasonography. Zahn’s pseudo infarction is an important differential diagnosis to wedge-shaped hepatic infarction in this context. Knowledge of the data should help raise awareness of these rare findings, to come up with relevant differential diagnoses in the corresponding clinical situation, to interpret the ultrasound images correctly and thus to initiate the appropriate diagnostic and therapeutic steps in time.

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Unexplained huge liver infarction presenting as a tumor with bleeding: A case report

Cited by 5 publications

References 23 publications

Hypervirulent Klebsiella pneumoniae Mediated Hepatic Infarction Septic Shock After Rectal Cancer Surgery: A Case Report

Hypervirulent Klebsiella pneumoniae Mediated Hepatic Infarction Septic Shock After Rectal Cancer Surgery: A Case Report

Contrast-enhanced ultrasound of the liver: Vascular pathologies and interventions

Comments and illustrations of the WFUMB CEUS liver guidelines: Rare vascular pathology, part II

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