Bronchobiliary fistula treated with histoacryl embolization under bronchoscopic guidance: A case report
|
|
- Francis Wade
- 5 years ago
- Views:
Transcription
1 Respiratory Medicine CME (2008) 1, respiratory MEDICINE CME CASE REPORT Bronchobiliary fistula treated with histoacryl embolization under bronchoscopic guidance: A case report Jung Hyun Kim a, Man Deuk Kim b, Young Kyung Lee b, Seong Gyu Hwang c, Ji Hyun Lee a, Eun Kyung Kim a, Hye Cheol Jeong a, a Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Bundang CHA Hospital, Pochon CHA University, 351 Yatap-dong, Sungnam City, Kyonggi-do , South Korea b Department of Radiology, Bundang CHA Hospital, Pochon CHA University, 351 Yatap-dong, Sungnam City, Kyonggi-do , South Korea c Division of Gastroenterology and Hepatology, Bundang CHA Hospital, College of Medicine, Pochon CHA University, 351 Yatap-dong, Sungnam City, Kyonggi-do , South Korea Received 12 March 2008; accepted 11 April 2008 KEYWORDS Bronchobiliary fistula; Bronchoscopy; Therapeutic embolization Summary A 56-year-old woman presented with bile-tinged sputum for one year. Five years ago, she was diagnosed with hepatocellular carcinoma. She was treated with five hepatic arterial chemotherapies, two radiofrequency ablations, four chemoembolizations, and a right lobectomy of the liver. Two years ago, a liver abscess with biliary stricture occurred and was treated with endoscopic biliary drainage and balloon dilatation. On admission, bronchoscopy suggested a bronchobiliary fistula in the anterobasal segment of the right lower lobar bronchus. Fluorography showed a fistulous tract between the right lower lobar bronchus and the liver abscess pocket. We performed histoacryl embolization under bronchoscopic guidance and the bile-tinged sputum resolved. However, biliary obstruction and hepatic failure followed and the patient expired three months later. We report a case of a bronchobiliary fistula managed with a bronchoscopic approach. & 2008 Elsevier Ltd. All rights reserved. Introduction Corresponding author. Tel.: ; fax: address: jhcmd@hanmail.net (H.C. Jeong). A bronchobiliary fistula (BBF) is a rare complication following liver disease, surgery, procedures, or trauma. Most therapeutic approaches aim to lower biliary tract pressure. 1 In cases of bronchopleural fistulae, bronchoscopic /$ - see front matter & 2008 Elsevier Ltd. All rights reserved. doi: /j.rmedc
2 Bronchoscopic embolization of bronchobiliary fistula 165 interventions have been tried, sometimes. However, only one case of a bronchoscopic approach has been reported for BBF. 2 We report a case of BBF after resection of a hepatoma treated with histoacryl embolization under bronchoscopic guidance. Case report A 56-year-old woman presented with bile-tinged sputum for one year. Twenty years before presentation, she was diagnosed as a hepatitis B virus carrier. Five years before presentation, she was diagnosed with liver cirrhosis and hepatocellular carcinoma in segments VI and VII (Figure 1). Because there was portal vein thrombosis, she received intra-hepatic arterial chemotherapy and 2340 cgy of external radiation therapy. After five cycles of hepatic arterial chemotherapy with cisplatin and 5-fluorouracil, computed tomography revealed decreased hepatocellular carcinoma and resolved portal vein thrombosis. The patient underwent two treatments of radiofrequency ablation (RFA) (Figure 1) and transcatheter arterial chemoembolization (TACE). Two years before presentation, she underwent surgical right lobectomy for recurrent hepatocellular carcinoma. Two months after surgery, biliary obstruction occurred and repeated endoscopic retrograde biliary drainage (ERBD) with plastic stent was performed (Figure 2), but the biliary obstruction was not resolved. Six months after surgery, a liver abscess with stent failure was diagnosed and treated with percutaneous abscess drainage and percutaneous transhepatic biliary drainage (PTBD) (Figure 3). Eleven months before presentation, bile-tinged sputum occurred and an immediate surgical fistulectomy was performed. After that, repeated PTBD and percutaneous balloon dilatation (PBD) for biliary stricture were performed (Figure 4), but bilioptysis persisted and three months before presentation she was admitted for recurrent pneumonia. On admission, she was not febrile. She complained of bilecolored sputum and cough in the morning. Her vital signs were normal. Physical examination showed crackles on the right lower lung field. Chest radiography revealed haziness on the right lower lung field and pleural effusion in the right hemithorax. There was no dysfunction in the percutaneous biliary drainage system. A complete blood count revealed mild anemia (hemoglobin of 9.4 g/dl). Blood chemistry showed a total bilirubin of 3.95 mg/dl and an elevated alkaline phosphatase of 260 IU/ L. The prothrombin time was 17.5 s. Bronchoscopy showed bile-colored material in the anterobasal segment of the right lower lobar bronchus (Figure 5). Figure 1 Liver CT of five years ago: (a) arterial phase reveals a huge mass at segments VI and VII. Portal vein thrombosis is present (arrow) and (b) after arterial chemotherapy and radiofrequency ablation. Figure 2 Biliary obstruction at two years before presentation. Endoscopic retrograde biliary drainage with plastic stent was performed.
3 166 J.H. Kim et al. Figure 3 Follow-up CTscan six months after surgery: (a) CT scan revealed liver abscess and (b) after percutaneous drainage, abscess pocket decreased. Figure 4 Cholangiogram via endoscopic approach. (a) Cholangiogram showed abscess pocket (arrow) and bronchus (arrowhead) is visualized through fistulous tract. (b) Percutaneous biliary balloon dilatation was performed. Figure 5 bronchus. Bronchoscopy revealed bile-colored material in the sub-segment of the anterobasal segment of the right lower lobar A chest computed tomography with multiplanar reconstruction suggested a BBF in the anterobasal and lateral basal segments (Figure 6). Fluorography under bronchoscopic guidance revealed a fistulous tract with an anterobasal segment of the right lower lobar bronchus and an abscess pocket in the liver (Figure 7). A guidewire was inserted via the bronchoscope channel into the anterobasal segment of the right lower lobe. A 5-Fr Berenstein catheter was passed over the guidewire. A microcatheter was placed into the abscess pocket of the liver. The abscess pocket and fistula tract were embolized with a mixture of 1 cc of histoacryl and 2 cc of lipiodol (Figure 7).
4 Bronchoscopic embolization of bronchobiliary fistula 167 After embolization, bilioptysis stopped and the chest radiograph showed a decreased extent of haziness in the right lower lung field (Figure 8). Although bilioptysis was resolved, biliary obstruction and bile peritonitis occurred. Three months later, she expired due to hepatic failure. Discussion Figure 6 The chest CT with multiplanar reconstruction. Consolidation in the anterobasal segment of the right lower lobe with peripheral bronchiectasis that communicated directly with the pleural space. A BBF is a rare complication of liver disease, trauma, procedures, or surgery. The most common cause of a BBF is a liver abscess. 3 In the United States, the most common cause of BBF is biliary obstruction. 4 Definitive treatment for a BBF is a surgical fistulectomy with soft tissue reconstruction. However, the surgical approach is accompanied by significant morbidity, mortality, and frequent reoperations. 3 Recently, conservative interventions have been the preferred procedure. Most interventions aim to lower biliary tract pressure; ERBD or PTBD is the preferred approaches. 1 Most patients respond well to these approaches, but it takes time for healing and some patients do not respond. There is one reported case of BBF treated with n-butyl cyanoacrylate (NBCA) embolization via a bronchial approach. 2 In that case, a BBF was developed after right hepatic Figure 7 Histoacryl embolization: (a) fluoroscopic image revealed abscess pocket (arrowhead) and fistulous tract (arrow), (b) dye was drained into biliary tree, and (c) after histoacryl emboliztion. Figure 8 Chest radiograph before (a) and after (b) embolization procedure.
5 168 lobectomy for single colon cancer metastasis. A 60% NBCA and 40% ethiodol mixture (3 cc) was used for embolization. In our case, BBF developed after lobectomy for hepatocellular carcinoma. Despite successful percutaneous biliary dilatation and PTBD, the patient complained of persistent bile-tinged sputum and recurrent pneumonia. We used histoacryl and lipiodol for embolization material. Tissue glue via a bronchoscopic approach is often used for bronchopleural fistulae. 5 In those cases, bronchoscopic intervention had an acceptable success rate without serious complications. The patient with colon cancer was free from symptoms for three months and died of cancer progression. 2 Our patient was also free from bilioptysis, but biliary obstruction and hepatic failure followed. Embolization under bronchoscopic guidance can be an effective option for BBF; however, one should pay attention to possible complications. References J.H. Kim et al. 1. Khandelwal M, Inverso N, Conter R, et al. Endoscopic management of a bronchobiliary fistula. J Clin Gastroenterol 1996;23: Goldman SY, Greben CR, Setton A, et al. Bronchobiliary fistula successfully treated with n-butyl cyanoacrylate via a bronchial approach. J Vasc Interv Radiol 2007;18: Borrie J, Shaw JHF. Hepatobronchial fistula caused by hydatid disease. The Dunedin experience Thorax 1981;36: Rose DM, Rose AT, Chapman WC, et al. Management of bronchobiliary fistula as a late complication of hepatic resection. Am Surg 1998;64: West D, Togo A, Kirk AJ. Are bronchoscopic approaches to postpneumonectomy bronchopleural fistula an effective alternative to repeat thoracostomy. Interact Cardiovasc Thorac Surg 2007;6: Conflict of interest statement The authors have no competing interests to declare. The manuscript has been reviewed and approved by all authors.
Gum O Jung and Dong Eun Park. Department of Surgery, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
Korean J Hepatobiliary Pancreat Surg 2012;16:110-114 Case Report Successful percutaneous management of bronchobiliary fistula after radiofrequency ablation of metastatic cholangiocarcinoma in a patient
More informationof bile leakage after liver resecti
NAOSITE: Nagasaki University's Ac Title Author(s) Citation Percutaneous embolization with n-bu of bile leakage after liver resecti Kuroki, Tamotsu; Kitasato, Amane; T Hiroaki; Taniguchi, Ken; Maeda, Shi
More informationBILIARY-BRONCHIAL FISTULA AS A LATE COMPLICATION OF HEPATIC RESECTION
Case Report BILIARY-BRONCHIAL FISTULA AS A LATE COMPLICATION OF HEPATIC RESECTION Adnan Al-Suleihat 1 SUMMARY Biliary-Bronchial Fistula (BBF) is a rare but serious complication of hepatic resection. We
More informationInterventional Radiology in Liver Cancer. Nakarin Inmutto MD
Interventional Radiology in Liver Cancer Nakarin Inmutto MD Liver cancer Primary liver cancer Hepatocellular carcinoma Cholangiocarcinoma Metastasis Interventional Radiologist Diagnosis Imaging US / CT
More informationBronchobiliary fistula caused after hepatectomy for hepatocellular carcinoma: a case report
Hai et al. Surgical Case Reports (2016) 2:147 DOI 10.1186/s40792-016-0273-z CASE REPORT Open Access Bronchobiliary fistula caused after hepatectomy for hepatocellular carcinoma: a case report Seikan Hai
More informationBiliary Anatomy in Living-related Liver Transplantation
The 5th IHPBA Congress - Istanbul Biliary Anatomy in Living-related Liver Transplantation biliary trees hilar plate Assessment for Vascular Anatomy 1. 3DCT portal vein hepatic vein hepatic artery 2. No
More informationHepatocellular Carcinoma: Diagnosis and Management
Hepatocellular Carcinoma: Diagnosis and Management Nizar A. Mukhtar, MD Co-director, SMC Liver Tumor Board April 30, 2016 1 Objectives Review screening/surveillance guidelines Discuss diagnostic algorithm
More informationA recurrent empyema with peripheral bronchopleural fistulas treated by retrograde bronchial sealing with Gore Tex plugs: a case report
Case Report A recurrent empyema with peripheral bronchopleural fistulas treated by retrograde bronchial sealing with Gore Tex plugs: a case report Jin-Young Ahn 1, Dohun Kim 2, Jong-Myeon Hong 2, Si-Wook
More informationBronchogenic Carcinoma
A 55-year-old construction worker has smoked 2 packs of ciggarettes daily for the past 25 years. He notes swelling in his upper extremity & face, along with dilated veins in this region. What is the most
More informationStaging & Current treatment of HCC
Staging & Current treatment of HCC Dr.: Adel El Badrawy Badrawy; ; M.D. Staging & Current ttt of HCC Early stage HCC is typically silent. HCC is often advanced at first manifestation. The selective ttt
More informationPostoperative Chylothorax: the Use of Dynamic Magnetic Resonance Lymphangiography and Thoracic Duct Embolization
pissn 2384-1095 eissn 2384-1109 imri 2018;22:182-186 Postoperative Chylothorax: the Use of Dynamic Magnetic Resonance Lymphangiography and Thoracic Duct Embolization Chae Woon Lee, Hyun Jung Koo, Ji Hoon
More informationNavigational Bronchoscopy with Transbronchial Radiofrequency Ablation
Navigational Bronchoscopy with Transbronchial Radiofrequency Ablation Katie S. Nason, MD MPH AATS Focus on Thoracic: Mastering Surgical Innovation October 28, 2017 No disclosures Radiofrequency ablative
More informationEndovascular Treatment of Type II Endoleak Following TEVAR for Thoracic Aortic Aneurysm: Squeeze Technique to Reach the Aneurysmal Sac
Endovascular Treatment of Type II Endoleak Following TEVAR for Thoracic Aortic Aneurysm: Squeeze Technique to Reach the Aneurysmal Sac Chang Won Kim Department of Radiology Pusan National University Hospital
More informationSurgical indications: Non-malignant pulmonary diseases. Punnarerk Thongcharoen
Surgical indications: Non-malignant pulmonary diseases Punnarerk Thongcharoen Non-malignant Malignant as a pathological term: Cancer Non-malignant = not cancer Malignant as an adjective: Disposed to cause
More informationMichele Bettinelli RN CCRN Lahey Health and Medical Center
Michele Bettinelli RN CCRN Lahey Health and Medical Center Differentiate the types of varices Identify glue preparations utilized when treating gastric varices Review the process of glue administration
More informationVascular complications in percutaneous biliary interventions: A series of 111 procedures
Vascular complications in percutaneous biliary interventions: A series of 111 procedures Poster No.: C-0744 Congress: ECR 2013 Type: Educational Exhibit Authors: A. BHARADWAZ; AARHUS, Re/DK Keywords: Obstruction
More informationHepatocellular Carcinoma HCC Updated November 2015 by: Dr. Mohammed Alghamdi (Medical Oncology Fellow, University of Calgary)
Hepatocellular Carcinoma HCC Updated November 2015 by: Dr. Mohammed Alghamdi (Medical Oncology Fellow, University of Calgary) Staff Reviewers: Dr. Yoo Joung Ko (Medical Oncologist, Sunnybrook Odette Cancer
More informationHepatocellular Carcinoma: A major global health problem. David L. Wood, MD Interventional Radiology Banner Good Samaritan Medical Center
Hepatocellular Carcinoma: A major global health problem David L. Wood, MD Interventional Radiology Banner Good Samaritan Medical Center Hepatocellular Carcinoma WORLDWIDE The #2 Cancer Killer Overall cancer
More informationHome Intravenous Antibiotic Treatment for Intractable Cholangitis in Biliary Atresia
Home Intravenous Antibiotic Treatment for Intractable Cholangitis in Biliary Atresia Hye Kyung Chang, Jung-Tak Oh, Seung Hoon Choi, Seok Joo Han Division of Pediatric Surgery, Department of Surgery, Yonsei
More informationEndobronchial ALK-Positive Anaplastic Large Cell Lymphoma Presenting Massive Hemoptysis
CSE REPORT http://dx.doi.org/10.4046/trd.2015.78.4.390 ISSN: 1738-3536(Print)/2005-6184(Online) Tuberc Respir Dis 2015;78:390-395 Endobronchial LK-Positive naplastic Large Cell Lymphoma Presenting Massive
More informationIntrahepatic Sarcomatoid Cholangiocarcinoma with Portal Vein Thrombosis: A Case Report 1
Intrahepatic Sarcomatoid Cholangiocarcinoma with Portal Vein Thrombosis: A Case Report 1 Jae-Hoon Lim, M.D., Jin Woong Kim, M.D., Suk Hee Heo, M.D., Yong Yeon Jeong, M.D., Heoung Keun Kang, M.D. A 53-year-old
More informationACUTE CHOLANGITIS AS a result of an occluded
Digestive Endoscopy 2017; 29 (Suppl. 2): 88 93 doi: 10.1111/den.12836 Current status of biliary drainage strategy for acute cholangitis Endoscopic treatment for acute cholangitis with common bile duct
More informationDo you want to be an excellent Radiologist? - Focus on the thoracic aorta on lateral chest image!!!
The lateral chest radiograph: Challenging area around the thoracic aorta!!! Do you want to be an excellent Radiologist? - Focus on the thoracic aorta on lateral chest image!!! Dong Yoon Han 1, So Youn
More informationPost-operative complications following hepatobiliary surgery: imaging findings and current radiological treatment options
Post-operative complications following hepatobiliary surgery: imaging findings and current radiological treatment options Poster No.: C-1501 Congress: ECR 2015 Type: Educational Exhibit Authors: A. Hadjivassiliou,
More informationCholangiocarcinoma (Bile Duct Cancer)
Cholangiocarcinoma (Bile Duct Cancer) The Bile Duct System (Biliary Tract) A network of bile ducts (tubes) connects the liver and the gallbladder to the small intestine. This network begins in the liver
More informationThoracostomy: An Update on Imaging Features and Current Surgical Practice
Thoracostomy: An Update on Imaging Features and Current Surgical Practice Robert D. Ambrosini, MD, PhD, Christopher Gange, MD, Katherine Kaproth-Joslin, MD, PhD, Susan Hobbs, MD, PhD Department of Imaging
More informationMultiple Primary Quiz
Multiple Primary Quiz Case 1 A 72 year old man was found to have a 12 mm solid lesion in the pancreatic tail by computed tomography carried out during a routine follow up study of this patient with adult
More informationEarly Klebsiella pneumoniae Liver Abscesses associated with Pylephlebitis Mimic
Early Klebsiella pneumoniae Liver Abscesses associated with Pylephlebitis Mimic Hepatocellular Carcinoma Chih-Hao Shen, MD 3, Jung-Chung Lin, MD, PhD 2, Hsuan-Hwai Lin, MD 1, You-Chen Chao, MD 1, and Tsai-Yuan
More informationRF Ablation: indication, technique and imaging follow-up
RF Ablation: indication, technique and imaging follow-up Trongtum Tongdee, M.D. Radiology Department, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand Objective Basic knowledge
More informationInterventional Radiology Curriculum for Medical Students
Cardiovascular and Interventional Radiological Society of Europe Interventional Radiology Curriculum for Medical Students C RSE Introduction It has been recognized that the teaching of radiology in medical
More informationPancreaticothoracic Fistula Presenting with Hemoptysis and Pneumothorax in a Chronic Alcoholic Patient
CASE REPORT http://dx.doi.org/10.4046/trd.2014.76.5.240 ISSN: 1738-3536(Print)/2005-6184(Online) Tuberc Respir Dis 2014;76:240-244 Pancreaticothoracic Fistula Presenting with Hemoptysis and Pneumothorax
More informationHepatopulmonary Fistula: a life threatening complication of hydatid disease
Gulamhussein et al. Journal of Cardiothoracic Surgery (2015) 10:103 DOI 10.1186/s13019-015-0311-0 CASE REPORT Hepatopulmonary Fistula: a life threatening complication of hydatid disease Open Access Mohamed
More informationLiver Cancer: Diagnosis and Treatment Options
Liver Cancer: Diagnosis and Treatment Options Fred Poordad, MD Chief, Hepatology University Transplant Center Professor of Medicine UT Health, San Antonio VP, Academic and Clinical Affairs, Texas Liver
More informationAPICAL SEGMENT OF THE LOWER LOBE IN RESECTIONS FOR BRONCHIECTASIS
Thorax (1955), 10, 137. THE LATE RESULTS OF THE CONSERVATION OF THE APICAL SEGMENT OF THE LOWER LOBE IN RESECTIONS FOR BRONCHIECTASIS BY E. HOFFMAN From the Regional Thoracic Surgery Centre, Shotley Bridge
More informationOutcome of donor biliary complications following living donor liver transplantation
ORIGINAL ARTICLE Korean J Intern Med 2018;33:705-715 Outcome of donor biliary complications following living donor liver transplantation Hyun Young Woo 1, In Seok Lee 2, Jae Hyuck Chang 2, Seung Bae Youn
More informationNYU School of Medicine Department of Radiology Rotation-Specific House Staff Evaluation
Vascular & Interventional Radiology Rotation 1 Core competency in vascular and interventional radiology during the first resident rotation consists of clinical objectives, technical objectives and image
More information담낭절제술후발생한미리찌증후군의내시경적치료 1 예
Case Report The Korean Journal of Pancreas and Biliary Tract 2014;19:199-203 http://dx.doi.org/10.15279/kpba.2014.19.4.199 pissn 1976-3573 eissn 2288-0941 담낭절제술후발생한미리찌증후군의내시경적치료 1 예 인하대학교의학전문대학원내과학교실 이정민
More informationDual Catheter Placement Technique for Treatment of Biliary Anastomotic Strictures After Liver Transplantation
LIVER TRANSPLANTATION 17:159-166, 2011 ORIGINAL ARTICLE Dual Catheter Placement Technique for Treatment of Biliary Anastomotic Strictures After Liver Transplantation Dong Il Gwon, 1 Kyu-Bo Sung, 1 Gi-Young
More informationA CASE REPORT OF SPONTANEOUS BILOMA - AN ENIGMATIC SURGICAL PROBLEM
A CASE REPORT OF SPONTANEOUS BILOMA - AN ENIGMATIC SURGICAL PROBLEM *Sumanta Kumar Ghosh and Biswajit Mukherjee ESIC Medical College, Joka, Kolkata, India *Author for Correspondence ABSTRACT Occurrence
More informationSurgical Management of CBD Injury Jin Seok Heo
Surgical Management of CBD Injury Jin Seok Heo Department of Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Republic of Korea Bile duct injury (BDI) Introduction Incidence
More informationManagement of Colorectal Liver Metastases
Management of Colorectal Liver Metastases MM Bernon, JEJ Krige HPB Surgical Unit, Groote Schuur Hospital Department of Surgery, University of Cape Town 50% of patients with colorectal cancer develop liver
More informationLiver Perfusion Analysis New Frontiers in Dynamic Volume Imaging. Case Study Brochure Chang Gung Memorial Hospital.
New Frontiers in Dynamic Volume Imaging dynamic volume CT Case Study Brochure Chang Gung Memorial Hospital http://www.toshibamedicalsystems.com Toshiba Medical Systems Corporation 2010-2011. All rights
More informationPreoperative Biliary Drainage Among Patients With Resectable Hepatobiliary Malignancy: Does Technique Matter?
Preoperative Biliary Drainage Among Patients With Resectable Hepatobiliary Malignancy: Does Technique Matter? Q. Lina Hu, MD; Jason B. Liu, MD, MS; Ryan J. Ellis, MD, MS; Jessica Y. Liu, MD, MS; Anthony
More informationScience & Technologies
A GIANT LIVER HYDATIDE CYST SIMULTANEOUSLY PERFORATED TO PERITONEAL AND PLEURAL CAVITIES A RARE CASE REPORT. Ivan P. Novakov Department of Special Surgery; Medical University - Plovdiv Abstract. Background.
More informationThe following are the objectives to be successfully completed by the IR fellow at the completion of training.
GOALS and OBJECTIVES The following are the objectives to be successfully completed by the IR fellow at the completion of training. I. Patient Care Fellows must be able to provide patient care that is compassionate,
More informationAbdominal Pain and Abnormal Liver Tests After Orthotopic Liver Transplantation
Abdominal Pain and Abnormal Liver Tests After Orthotopic Liver Transplantation M. Muñoz-Navas 1, J. Baillie 2 1 University of Pamplona, Pamplona, Spain [Guest Discussant] 2 Dept. of Medicine, Duke University
More informationIntraluminal Brachytherapy after Metallic Stent Placement in Primary Bile Duct Carcinoma 1
Intraluminal Brachytherapy after Metallic Stent Placement in Primary Bile Duct Carcinoma 1 Kyu-Hong Park, M.D., Soon Gu Cho, M.D., Sung-Gwon Kang, M.D. 1,2, Don Haeng Lee, M.D. 3, Woo Cheol Kim, M.D. 4,
More informationTRANSEARTERIAL CHEMO- EMBOLIZATION FOR HEPATIC METASTASES FROM NEURO-ENDOCINE NEOPLASIA AND HEPATOMA DR SAMIA AHMAD
UNIVERSITY OF PRETORIA STEVE BIKO ACADEMIC HOSPITAL SOUTH AFRICA TRANSEARTERIAL CHEMO- EMBOLIZATION FOR HEPATIC METASTASES FROM NEURO-ENDOCINE NEOPLASIA AND HEPATOMA DR SAMIA AHMAD 1 INTRODUCTION Hepatic
More informationpitfall Table 1 4 disorientation pitfall pitfall Table 1 Tel:
11 687 692 2002 pitfall 1078 29 17 9 1 2 3 dislocation outflow block 11 1 2 3 9 1 2 3 4 disorientation pitfall 11 687 692 2002 Tel: 075-751-3606 606-8507 54 2001 8 27 2002 10 31 29 4 pitfall 16 1078 Table
More informationThe Surgical Treatment of Tracheobronchial Tuberculosis. The Thoracic Department of Beijing Chest Hospital, Capital Medical University
The Surgical Treatment of Tracheobronchial Tuberculosis ) The Thoracic Department of Beijing Chest Hospital, Capital Medical University Named also: endobronchial tuberculosis,ebtb defined as tuberculous
More informationINTRODUCTION. Key Words: Biliary stenting; Biliary stricture; Duct-toduct biliary anastomosis; Endoscopic retrograde cholangiography; original article
Gut and Liver, Vol. 4, No. 2, June 2010, pp. 226-233 original article Biliary Stricture after Adult Right-Lobe Living-Donor Liver Transplantation with Duct-to-Duct Anastomosis: Long-Term Outcome and Its
More informationTo evaluate 792 patients with malignant biliary obstruction after inner-stents drainage procedure
To evaluate 792 patients with malignant biliary obstruction after inner-stents drainage procedure Zhu wei, Zhang xiquan, Pan xiaolin, Dong ge, Guo feng. The Cardio-Interventional Center, The 148th PLA
More informationRight Lower Lobe Bronchopleural Fistula Treated with a Novel, Y-shaped, Single-Plugged, Covered, Metallic Airway Stent
Right Lower Lobe Bronchopleural Fistula Treated with a Novel, Y-shaped, Single-Plugged, Covered, Metallic Airway Stent Gang Wu 1, Zong-Ming Li 1, Jia-Xiang Wang 2*, Xin-Wei Han 1, De-Chao Jiao 1, Ming
More informationRadiology. Undergraduate Radiology Sample Questions
Radiology Undergraduate Radiology Sample Questions April 2012 The following examples are offered of questions that might be used to assess undergraduate radiology. There are 3 different styles: An OSCE
More informationPDF hosted at the Radboud Repository of the Radboud University Nijmegen
PDF hosted at the Radboud Repository of the Radboud University Nijmegen The following full text is a publisher's version. For additional information about this publication click this link. http://hdl.handle.net/2066/23566
More informationREPEATED INTRANODAL LYMPHANGIOGRAPHY FOR THE TREATMENT OF LYMPHATIC LEAKAGE
59 Lymphology 48 (2015) 59-63 REPEATED INTRANODAL LYMPHANGIOGRAPHY FOR THE TREATMENT OF LYMPHATIC LEAKAGE S. Kariya, M. Nakatani, R. Yoshida, Y. Ueno, A. Komemushi, N. Tanigawa Department of Radiology,
More informationISPUB.COM. Rare Cases: Tracheal/bronchial Obstruction. O Wenker, L Moehn, C Portera, G Walsh HISTORY ADMISSION
ISPUB.COM The Internet Journal of Radiology Volume 1 Number 1 O Wenker, L Moehn, C Portera, G Walsh Citation O Wenker, L Moehn, C Portera, G Walsh.. The Internet Journal of Radiology. 1999 Volume 1 Number
More informationImaging of liver and pancreas
Imaging of liver and pancreas.. Disease of the liver Focal liver disease Diffusion liver disease Focal liver disease Benign Cyst Abscess Hemangioma FNH Hepatic adenoma HCC Malignant Fibrolamellar carcinoma
More informationPortal Vein Embolization with highly
Portal Vein Embolization with highly diluted NBCA Personal experience Fabrice DEPREZ MD.MSM.EBIR Jean-François DE WISPELAERE MD CHU UCL Namur Site Godinne CVIR BSR Section Meeting 10/10/2016 CHU Dinant
More informationLin Yang, Xiao Ming Zhang, Yong Jun Ren, Nan Dong Miao, Xiao Hua Huang, and Guo Li Dong
Radiology Research and Practice Volume 2013, Article ID 535272, 6 pages http://dx.doi.org/10.1155/2013/535272 Clinical Study The Features of Extrahepatic Collateral Arteries Related to Hepatic Artery Occlusion
More informationIatrogenic Cardiac Injuries. Kings County Hospital Center Verena Liu, MD 9/1/2011
Iatrogenic Cardiac Injuries Kings County Hospital Center Verena Liu, MD 9/1/2011 Case Presentation 69 year old male recently diagnosed with a 3.8 cm x 4.3 cm hepatocellular CA in the superior segment of
More informationCorrespondence should be addressed to Justin Cochrane;
Case Reports in Gastrointestinal Medicine Volume 2015, Article ID 794282, 4 pages http://dx.doi.org/10.1155/2015/794282 Case Report Acute on Chronic Pancreatitis Causing a Highway to the Colon with Subsequent
More informationLiver Tumors. Patient Education. Treatment options 8 4A. About the Liver. Surgical Specialties
Patient Education Treatment options This handout describes different kinds of tumors that form in the liver and how they are treated. About the Liver Your liver is the largest organ in your abdomen. It
More informationPercutaneous biliary drainage: complications and efficiency at short and mean terms: about 50 cases
Percutaneous biliary drainage: complications and efficiency at short and mean terms: about 50 cases Poster No.: C-1497 Congress: ECR 2016 Type: Scientific Exhibit Authors: M. Matri, L. Ben Farhat, I. Marzouk
More informationComplications of percutaneous lung radiofrequency ablation
Complications of percutaneous lung radiofrequency ablation Poster No.: C-556 Congress: ECR 2009 Type: Educational Exhibit Topic: Interventional Radiology Authors: A. Afaq, S. Khan, U. Patel, E. Leen; London/UK
More informationManagement of the Mucin Filled Bile Duct. A Complication of Intraductal Papillary Mucinous Tumor of the Pancreas
CASE REPORT Management of the Mucin Filled Bile Duct. A Complication of Intraductal Papillary Mucinous Tumor of the Pancreas Anand Patel, Louis Lambiase, Antonio Decarli, Ali Fazel Division of Gastroenterology
More informationLung cancer in patients with chronic empyema
Lung cancer in patients with chronic empyema Poster No.: P-0025 Congress: ESTI 2015 Type: Scientific Poster Authors: Y. Lee, C.-K. Park; Guri/KR Keywords: Neoplasia, Biopsy, PET-CT, CT, Thorax, Lung DOI:
More informationAppendix 5. EFSUMB Newsletter. Gastroenterological Ultrasound
EFSUMB Newsletter 87 Examinations should encompass the full range of pathological conditions listed below A log book listing the types of examinations undertaken should be kept Training should usually
More informationtreatment options for primary liver malignancies and metastatic disease
State of the art treatment options for primary liver malignancies and metastatic disease Peter Huppert Prof. of Radiology and Neuroradiology Klinikum Darmstadt Certified Vascular and Oncologic Center Disclosure
More informationMDCT findings after hepatic chemoembolization with DC-beads: What the radiologist needs to know
Abdominal Imaging ª Springer Science+Business Media New York 2012 Published online: 10 October 2012 Abdom Imaging (2013) 38:778 784 DOI: 10.1007/s00261-012-9963-6 MDCT findings after hepatic chemoembolization
More informationEvaluation and Management of Refractory Biliary Stricture. J. David Horwhat, MD, FACG Director of Endoscopy Lancaster Gastroenterology, Inc.
Evaluation and Management of Refractory Biliary Stricture J. David Horwhat, MD, FACG Director of Endoscopy Lancaster Gastroenterology, Inc Outline What defines a refractory biliary stricture Endoscopic
More informationHepatocellular Carcinoma Rupture after Transcatheter Arterial Chemoembolization
Chin J Radiol 2004; 29: 41-45 41 Hepatocellular Carcinoma Rupture after Transcatheter Arterial Chemoembolization KUNG-SHIH YING 1 SHYUH-HUEI HUANG 2 CHE-JEN CHAO 3 SHIN-HWA WU 1 TAI-YU CHANG 1 CHUNG-HSEIN
More informationThe Occurrence of a Pseudoaneurysm of the Hepatic Artery within the Thrombosed Portal Vein of a Patient with Chronic Pancreatitis: A Case Report 1
The Occurrence of a Pseudoaneurysm of the Hepatic Artery within the Thrombosed Portal Vein of a Patient with Chronic Pancreatitis: A Case Report 1 Eun Soo Kim, M.D., Kyung Mi Jang, M.D., Min-Jeong Kim,
More informationTotal collapse of the lung in aspergillosis
Thorax (1965), 20, 118. Total collapse of the lung in aspergillosis R. H. ELLIS From the Gloucestershire Royal Hospital, Pulmonary aspergillosis can be divided conveniently into two main types, allergic
More informationThe Egyptian Journal of Hospital Medicine (July 2018) Vol. 72 (9), Page
The Egyptian Journal of Hospital Medicine (July 2018) Vol. 72 (9), Page 5153-5160 Role of Interventional Radiology in the Management of Postoperative Biliary Complications 1 Hana Hamdy Nasif, 1 Mennatallah
More informationLocoregional Therapy for Hepatoma
Locoregional Therapy for Hepatoma Robert D. Crane, MD Interventional Radiology Virginia Mason How do we know a liver mass is HCC? HCC : Bx Of pts getting liver transplant only ~ 5% had Bx to establish
More informationEndoscopic stenting in bile duct cancer increases liver volume
Endoscopic stenting in bile duct cancer increases liver volume Chang Hun Lee 1,3, Seung Young Seo 1,3, Seong Hun Kim 1,3, In Hee Kim 1,3, Sang Wook Kim 1,3, Soo Teik Lee 1,3, Dae Ghon Kim 1,3, Jae Do Yang
More informationRobotic-assisted right inferior lobectomy
Robotic Thoracic Surgery Column Page 1 of 6 Robotic-assisted right inferior lobectomy Shiguang Xu, Tong Wang, Wei Xu, Xingchi Liu, Bo Li, Shumin Wang Department of Thoracic Surgery, Northern Hospital,
More informationAfferent Loop Syndrome: Treatment by Means of the Placement of Dual Stents
Vascular and Interventional Radiology Original Research Han et al. Use of Dual Stents for Treatment of Afferent Loop Syndrome Vascular and Interventional Radiology Original Research Kichang Han 1 Ho-Young
More informationMULTI-DISCIPLINARY MANAGEMENT OF INTERMEDIATE STAGE HCC
Dr Apoorva Gogna MBBS FRCR FAMS Consultant Interventional Radiology Center Department of Diagnostic Radiology SingaporeGeneral Hospital MULTI-DISCIPLINARY MANAGEMENT OF INTERMEDIATE STAGE HCC CASE HISTORY
More informationThe Egyptian Journal of Hospital Medicine (October 2017) Vol.69(1), Page
The Egyptian Journal of Hospital Medicine (October 2017) Vol.69(1), Page 1674-1679 Radioembolization in Treatment of Hepatocellular Carcinoma with Portal Vein Invasion Elsahhar Ahmed Hetta, Osama Mohamed
More informationCommon things are common, but not always the answer
Kevin Conroy, Joe Mackenzie, Stephen Cowie kevin.conroy@nhs.net Respiratory Dept, Darlington Memorial Hospital, Darlington, UK. Common things are common, but not always the answer Case report Cite as:
More informationCase Report Thoracic Imaging. Eun Kyung Khil, MD 1, Heon Lee, MD, PhD 1, Keun Her, MD 2 INTRODUCTION CASE REPORT
Case Report Thoracic Imaging http://dx.doi.org/10.3348/kjr.2014.15.1.173 pissn 1229-6929 eissn 2005-8330 Korean J Radiol 2014;15(1):173-177 Spontaneous Intramural Full-Length Dissection of Esophagus Treated
More informationCerebral Air Embolism Following Pigtail Catheter Insertion for Pleural Fluid Drainage
http://dx.doi.org/10.4046/trd.2013.74.6.286 ISSN: 1738-3536(Print)/2005-6184(Online) Tuberc Respir Dis 2013;74:286-290 CopyrightC2013. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights
More informationSIR 2008 Annual Meeting Film Panel Case: Radiation-induced Angiosarcoma
Special Communications SIR 2008 Annual Meeting Film Panel Case: Radiation-induced Angiosarcoma Daniel Y. Sze, MD, PhD, and Judy H. Huang, MD J Vasc Interv Radiol 2008; 19:1133 1137 HISTORY From the Division
More informationBILIARY TRACT & PANCREAS, PART II
CME Pretest BILIARY TRACT & PANCREAS, PART II VOLUME 41 1 2015 A pretest is mandatory to earn CME credit on the posttest. The pretest should be completed BEFORE reading the overview. Both tests must be
More informationRecurrent Retropharyngeal Abscess with Esophageal Perforation due to Chopstick Injury
Recurrent Retropharyngeal Abscess with Esophageal Perforation due to Chopstick Injury Hye Kyung Chang, Jung-Tak Oh, Seung Hoon Choi, Seok Joo Han Division of Pediatric Surgery, Department of Surgery, Yonsei
More informationPalliative Treatment of Malignant Esophagopulmonary Fistulas With Covered Expandable Metallic Stents
Vascular and Interventional Radiology Original Research Vascular and Interventional Radiology Original Research FOCUS ON: Kyung Rae Kim 1,2 Ji Hoon Shin 2 Ho-Young Song 2 Gi-Young Ko 2 Jin Hyoung Kim 2
More informationSystemic lupus erythematosus (SLE): Pleuropulmonary Manifestations
08/30/10 09/26/10 Systemic lupus erythematosus (SLE): Pleuropulmonary Manifestations Camila Downey S. Universidad de Chile, School of Medicine, Year VII Harvard University, School of Medicine Sept 17,
More informationAdvances in percutaneous ablation for hepatocellular carcinoma
Advances in percutaneous ablation for hepatocellular carcinoma P. Nahon1,2,3 1 Hepatology, Jean Verdier Hospital, APHP, Bondy, France 2 Paris 13 university, Sorbonne Paris Cité, UFRSMBH, Bobigny, France
More informationEGIS BILIARY STENT. 1. Features & Benefits 2. Ordering information 3. References
EGIS BILIARY STENT 1. Features & Benefits 2. Ordering information 3. References 1. Features & Benefits (1) Features Superior flexibility & conformability 4 Types Single bare, Single cover, Double bare,
More informationCurrent Treatment of Colorectal Metastases. Dr. Thavanathan Surgical Grand Rounds February 1, 2005
Current Treatment of Colorectal Metastases Dr. Thavanathan Surgical Grand Rounds February 1, 2005 25% will have metastases at initial presentation 25-50% 50% will develop metastases later 40% of potentially
More informationPersonal Profile. Name: 劉 XX Gender: Female Age: 53-y/o Past history. Hepatitis B carrier
Personal Profile Name: 劉 XX Gender: Female Age: 53-y/o Past history Hepatitis B carrier Chief complaint Fever on and off for 2 days Present illness 94.10.14 Sudden onset of epigastric pain 94.10.15 Fever
More informationOCCULT COLON CANCER IN A PATIENT WITH DIABETES AND RECURRENT KLEBSIELLA
OCCULT COLON CANCER IN A PATIENT WITH DIABETES AND RECURRENT KLEBSIELLA PNEUMONIAE LIVER ABSCESS Wen-Hung Hsu, 1 Fang-Jung Yu, 1 Chien-Han Chuang, 2 Chin-Fan Chen, 3 Chien-Ting Lee, 4 and Chien-Yu Lu 1,5
More informationJMSCR Volume 03 Issue 04 Page April 2015
www.jmscr.igmpublication.org Impact Factor 3.79 ISSN (e)-2347-176x A Rare Case of Boerhaaves Syndrome Managed Conservatively Authors Dr. Vinaya Ambore 1, Dr. Vikram Wagh 2, Dr. Prashant Turkar 3, Dr. Kapil
More informationP53 Gene Therapy for Pulmonary Metastasis Tumor from Hepatocellular Carcinoma
P53 Gene Therapy for Pulmonary Metastasis Tumor from Hepatocellular Carcinoma Anti-Cancer Drugs, 2010,21(9):882-884 Miao Yu, Wei Chen, Jinshan Zhang Miao Yu: Department of Department of Interventional
More informationTrans-arterial radioembolisation (TARE) of unresectable HCC using Y-90 microspheres: is it dangerous in case of portal vein thrombosis?
Trans-arterial radioembolisation (TARE) of unresectable HCC using Y-90 microspheres: is it dangerous in case of portal vein thrombosis? Poster No.: C-1634 Congress: ECR 2014 Type: Authors: Keywords: DOI:
More informationAppendix to Gibson et al. Application of a decision rule and a D-dimer assay in the
Appendix to Gibson et al. Application of a decision rule and a D-dimer assay in the diagnosis of pulmonary embolism (Thromb Haemost 2010; 103.4) Case 1 You are paged by an emergency room physician, who
More informationBasics of Interventional Radiology Coding 2018
Basics of Interventional Radiology Coding 2018 Prepared and Published By: MedLearn Publishing A Division of MedLearn Media, Inc. 445 Minnesota Street, Suite 514 St. Paul, MN 55101 1-800-252-1578 medlearnmedia.com
More information100% pure beta emitter Decays to zirconium-90 Physical half-life of 64.1 hours (2.67 days) 94% of radiation delivered within 11 days
100% pure beta emitter Decays to zirconium-90 Physical half-life of 64.1 hours (2.67 days) 94% of radiation delivered within 11 days TheraSphere [US package insert]. Surrey, UK: Biocompatibles UK Ltd,
More information