The liver has a dual blood supply, involving the hepatic artery and the portal vein. In addition to that, it has a well-developed collateral system, thus hepatic infarction (HI) is not a frequent ailment [1]. HI occurs when both aforementioned major blood vessels are compromised, leading to ischemia of the liver parenchyma. This, in turn, leads to coagulative necrosis of hepatic tissue. Portal vein thrombosis is often the precipitating factor in HI. There are various causes of HI, including iatrogenic, infective, vascular, post-traumatic and coagulopathic events.

Examples of specific conditions that predispose to HI include those that compromise blood flow to the liver, that is, hypercoagulable states, portal vein thrombosis, hepatic artery occlusion and atherosclerosis. Further, the situations that increase an individual's susceptibility to HI include diabetes, hypovolemia and shock, sepsis and biliary tree disease. Recorded iatrogenic factors include surgical interventions, both open and laparoscopic, liver transplant, and vascular procedures such as trans-catheter arterial embolization and intra-arterial chemoinfusion [1]. Other elements that increase the risk of HI entail vasoconstrictors that act centrally (thus affecting the blood supply of abdominal organs), atherosclerosis and pancreatitis [2] [3] [4].

Patients with HI may be asymptomatic [5]. In the symptomatic individuals, onset is sudden, and common complaints are right upper quadrant pain, fever, jaundice and gastrointestinal upset [6]. Diabetics may not report any pain, due to neuropathy related to hyperglycemia. The white cell count, aspartate transaminase (AST) and alanine transaminase (ALT) are often raised. This medical entity is common in people who underwent a liver transplant.

• Right Flank Pain

  Two months later, she experienced right hypochondralgia and right flank pain. Serum transaminase levels were suddenly elevated, and computed tomography scans of the liver showed multiple small nodular lesions. [ncbi.nlm.nih.gov]

• Severe Abdominal Pain

  We present a patient who in the third trimester of pregnancy developed severe abdominal pain, fever and transaminases greater than 30 times normal. [ncbi.nlm.nih.gov]

  Physical findings range from low-grade fever, mild to severe abdominal pain radiating to the back and ileus. Features of severe disease include hematochezia, ascites, metabolic acidosis, and renal or respiratory failure. [saudijobesity.com]

• Ulcer

  The diagnosis of ulcerative colitis was made 5 mo after recovery from severe hepatic failure. [ncbi.nlm.nih.gov]

  Peptic ulcer and its course in cirrhosis: An endoscopic and clinical prospective study. J Hepatol 1995;22:633-64. Kalaitzakis E, Björnsson E. [sapd.es]

  Extra-hepatic manifestations including arthropathy, rash and leg ulcers can occur. Treatment with plasma exchange has been successful. [sickle.bwh.harvard.edu]

• Muscle Weakness

  Her case history included the following: 20 years of paroxysmal arterial fibrillation under treatment with warfarin potassium; 10 years of hypertension and diabetes with drug resistance and 5 years of proximal muscle weakness. [edmcasereports.com]

• Renal Insufficiency

  Thirteen developed hepatic encephalopathy and other complications, including hypoglycaemia (55%), renal insufficiency (50%) requiring haemofiltration, coagulopathy (96%) and disseminated intravascular coagulopathy (55%) and pre‐eclampsia (50%). [academic.oup.com]

• Polyneuropathy

  壊血病 scorbutus 核黄疸 Kernikterus (独), kernicterus, nuclear jaundice 家族性アミロイドーシス familial amyloidosis 家族性アミロイドポリニューロパチー familial amyloidotic polyneuropathy 家族性LCAT欠損症 familial lecithin cholesterol acyltransferase deficiency 家族性高コレステロール血症 familial hypercholesterolemia [jsge.or.jp]

• Dizziness

  He had no history of recent travel, recent sick contacts, trauma, pain with eating, fever, chills, shortness of breath, chest pain, headaches, dizziness, changes in bowel movements, or urination. The patient confirmed a past surgical histor... [medworm.com]

Hepatic infarction is best diagnosed via abdominal computerized tomography (CT) scans. Both contrast and non-contrast CTs are used. Non-contrast CT shows an HI as a wedge shaped area of low attenuation. Contrasted CT may highlight impaired perfusion in the infarcted tissue [7]. The site, extent and possible underlying pathology of the HI can be assessed using a CT scan [8]. Abdominal ultrasound examination may reveal hypoechoic lesions and calcifications that suggest infarction. Complications of HI, particularly those of the biliary tree, include abnormal collections of bile, and biliary strictures [9].

Physical examination is important. Positive findings could include jaundice, which may indicate liver failure [6].

Biochemical studies may show elevated aminotransaminase, whereas increased levels of serum bilirubin as well as abnormalities in clotting studies, exemplified by prolonged prothrombin time (PT) and international normalized ratio (INR), are possible findings [5] [6]. Ultrasound scanning and angiography are both useful in locating blockage of a vessel. Nuclear imaging helps in visualizing the areas of necrosis.

Different types of angiography can be used, including CT and magnetic resonance (MR).

We believe that liver cirrhosis and chronic pancreatitis were the main risk factors for the portal thrombosis, and the treatment for esophageal varices appeared to have triggered the thrombosis. [ncbi.nlm.nih.gov]

It was diagnosed hepatic infarction with portal venous gas, and we thought it was caused by the RFA treatment. Occurrence of hepatic infarction after RFA treatment is quite rare. [jstage.jst.go.jp]

This article describes a severe complication of this treatment. A 43-year-old male patient was sent to our department for treatment of hepatic metastases. [elsevier.es]

Thromboprophylaxis and antiplatelet therapy should be considered in treatment of glucocorticoid excess or glucocorticoid withdrawal. [edmcasereports.com]

The authors evaluated the frequency of hepatic infarction, clinical features, initial and follow-up CT findings, accompanied complications, and prognosis. Potential risk factors were evaluated with multiple logistic regression analysis. [ncbi.nlm.nih.gov]

Prognosis The prognosis is mostly related to the severity of the underlying systemic disease. Causes Hepatic artery damage due to..... [gastroenterologybook.com]

Classification and staging are discussed at length with reference to treatment planning and correlation to prognosis. Diagnostic tools including X-Ray, CT scan, MRI and bone scan are also described in detail. [books.google.ro]

Ischemic hepatitis is generally benign and self-limited, and prognosis is more related to the underlying etiology of shock. [errolozdalga.com]

However Transfer-Tox is a far superior formula Hepatic Infarction Treatment Tumor Itk Segmentation and better for you than just Milk Thistle. https://www.pkpi.eu/103/liver-failure-prognosis-alcohol-after-surgery-regeneration/ http://0-www.gpo.gov.librus.hccs.edu [pkpi.eu]

The etiology, clinical course, and radiologic features of liver infarction are summarized, and the importance of recognizing and treating this form of hypercoagulability is stressed. [ncbi.nlm.nih.gov]

The identification of bleeding foci, as well as the etiology of varices, can be challengi... [medworm.com]

Ischemic hepatitis is generally benign and self-limited, and prognosis is more related to the underlying etiology of shock. [errolozdalga.com]

Portomesenteric thrombosis following laparoscopic bariatric surgery: Incidence, patterns of clinical presentation, and etiology in a bariatric patient population. JAMA Surg 2013;148:340-6. 2. [saudijobesity.com]

Glomerular filtration rate (eGFR CKD-EPI ) was estimated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) study equation [ 13 ]. [journals.plos.org]

[…] mutated hepatocellular adenoma (HA-B, ~10%) Inflammatory hepatocellular adenoma (HA-I, ~35%) Sonic hedgehog ( SHH ) hepatocellular adenoma (HA-sh, ~5%) Hepatocellular adenoma, not otherwise specified (HA-U, ~7%) ICD coding D13.4 : Benign neoplasm of liver Epidemiology [pathologyoutlines.com]

We precisely assessed both hepatic hemodynamics and hepatocellular function using sequential multidetector computed tomography and gadoxetate disodium-enhanced magnetic resonance imaging, which may provide useful information on the pathophysiological [ncbi.nlm.nih.gov]

Despite nearly 200 reports in the last 15 years on the hepato-biliary aspects of the sickling disorders, the frequency and pathophysiology of hepatic lesions remain unclear. [sickle.bwh.harvard.edu]

[…] contraceptive pills, approximately 3 per 100,000 ( N Engl J Med 1976;294:470 ) Additional risk factors include anabolic steroids, noncontraceptive estrogen supplements, obesity and metabolic syndrome Mean age = 37 - 41 years Rare in pediatric patients Pathophysiology [pathologyoutlines.com]

Nitric oxide dysfunction in the pathophysiology of preeclampsia [Review] [204 refs]. Nitric Oxide 2000 ; 4 : 441 –58. 18 Anumba DO, Robson SC, Boys RJ, Ford GA. [academic.oup.com]

It typically arises in the third trimester of pregnancy, although it has been reported as early as 13 weeks' gestation. 18 – 20 The pathophysiology of intrahepatic cholestasis of pregnancy remains poorly understood. 19 Pruritus alone occurs in 80 percent [aafp.org]

CONCLUSIONS: Attention should be paid to inadvertent injury of hepatic artery to prevent hepatic infarction. [ncbi.nlm.nih.gov]

However, specific guidelines for the prevention of thrombosis in such patients have not been described. [edmcasereports.com]

Milk thistle (aka silymarin) is a dietary supplement traditionally used by herbalists to treat and to prevent damage to the liver. – Best food in NW Wisconsin –Local and Organic options: Helps the liver to regenerate There are many herbs and ingredient [pkpi.eu]

Preeclampsia prevention: lessons from the low‐dose aspirin therapy trials [Review] [25 refs]. Am J Obstet Gynecol 2000 ; 183 : 523 –8. 24 Rogers MS, Fung HY, Hung CY. [academic.oup.com]

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