UNIGE document Scientific Article
previous document  unige:916  next document
add to browser collection
Title

Focal ischemic necrosis in advanced biliary atresia cirrhosis

Authors
Published in Pediatric transplantation. 2008, vol. 12, no. 4, p. 487-91
Abstract This report correlates the clinical and biological findings, liver hemodynamics and histological features of focal INL in an infant with BA cirrhosis. An eight month old boy with BA, with previous successful porto-enterostomy, was admitted with signs of cholangitis and ascites. He was treated with antibiotics and diuretics with subsequent clinical improvement. Eight days later, while being fed with hyper-osmolar milk, he became febrile again: ASAT/ALAT climbed (9000/2300 IU/L), liver function deteriorated. Infectious work-up was negative. Liver-ultrasound showed reversed portal flow and a negative arterial diastolic flow. The patient recovered within five days under supportive treatment. A similar event recurred five days later. INL was suspected and semi-urgent living-related liver transplantation was performed, with uneventful post-operative course. Histology of the explanted liver showed extensive foci of INL of different ages. This report illustrates how the association of reversed portal and arterial diastolic flows, with subsequent liver hypoperfusion, may repeatedly cause foci of INL in BA cirrhosis, and lead to rapid progression to liver failure. Because of precarious hepatic blood supply in such patients, close monitoring of portal and diastolic arterial flows is recommended.
Keywords Biliary Atresia/pathologyGraft SurvivalHumansInfantIschemiaLiver/metabolism/pathology/ultrasonographyLiver Cirrhosis/pathologyLiver Failure/therapyLiver Transplantation/methodsMaleNecrosis/diagnosis/pathologyTreatment OutcomeUltrasonography, Doppler/methods
Identifiers
PMID: 18331537
Full text
Structures
Research groups Gastroentérologie et transplantation (pédiatrie) (181)
Hépatologie chirurgicale (327)
Métastases du foie (657)
Recherche clinique en chirurgie pédiatrique (886)
Plateforme d'oncologie et d'hématologie pédiatrique (907)
Citation
(ISO format)
WILDHABER, Barbara et al. Focal ischemic necrosis in advanced biliary atresia cirrhosis. In: Pediatric transplantation, 2008, vol. 12, n° 4, p. 487-91. https://archive-ouverte.unige.ch/unige:916

254 hits

1 download

Update

Deposited on : 2009-02-25

Export document
Format :
Citation style :