• Title/Summary/Keyword: Hepatic vein

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Hepatic Scintigraphic Findings of Budd-Chiari Syndrome due to Inferior Vena Caval Obstruction (하대정맥 폐색으로 인한 Budd-Chiari 증후군의 간신티그램 소견)

  • Kim, Sung-Hoon;Chung, Soo-Kyo;Byun, Jae-Young;Lee, Sung-Yong;Shinn, Kyung-Sub;Kim, Choon-Yul;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.22 no.1
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    • pp.47-53
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    • 1988
  • Budd-Chiari syndrome (BCS) is a rare clinical entity characterized by post-sinusoidal portal hypertension caused by the obstruction to the hepatic vein outflow The diagnosis is suggested by hepatic scintigraphy and is usually confirmed by hepatic venography, inferior vena cavography and biopsy. The scintigraphic finding of BCS caused by the obstruction of main hepatic vein has been reported to consist typically of hypertrophy of the caudate lobe with increased radionuclide accumulation. Such a typical finding has been accounted for by the fact that the venous outflow from the caudate lobe is preserved when the main hepatic vein is obstructed. But usually, the hepatic venous outflow from the caudate lobe is also obstructed in BCS due to inferior vena caval obstruction. So hepatic scintigraphic findings of BCS due to inferior vena caval obstruction show different findings as compared with the BCS due to hepatic vein obstruction. We evaluate the hepatic scintigrams of the 13 cases of BCS due to inferior vena caval obstruction and review the literatures. The results are as follows : 1) We cannot observe the caudate lobe hypertrophy with increased uptake, which is known as a classic finding in BCS due to hepatic vein obstruction. 2) The most prominent hepatic scintigraphic findings of BCS are nonhomogenous uptake in the liver with extrahepatic uptake in the all cases. 3) We can see cold areas at the superior aspect of right hepatic lobe in 7 cases (54%). This is a useful finding suggesting BCS due to inferior vena caval obstruction.

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Distribution of Hepatic Vein within Liver of Korean Native Goat (한국재래산양(韓國在來山羊)의 간정맥(肝靜脈)에 관하여)

  • Kim, Chong-Sup
    • Korean Journal of Veterinary Research
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    • v.16 no.2
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    • pp.197-200
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    • 1976
  • By employing the vinylite corrosion technique, the distribution of the hepatic vein within the liver in 50 Korean native goats was observed. 1. In 50 vinylite casts, the principal branches of hepatic vein are Vena hepatica sinistra, Vena hepatica sinistra et medialis, Vena heapati dextralateralis et medialis, Vena hepatica caudatorum, Vena hepatica dorsolateralits: three chief branches are Vena hepatica sinistra, Vena hepatica dextra, Vena hepatica caudatorum. 2. In the liver of Korean goat are recognized three lobes, i.e. Lobus sinister, Lobus dexter and Lobus caudate.

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Spontaneous hepatic arterioportal fistula in extrahepatic portal vein obstruction: Combined endovascular and surgical management

  • Ananya Panda;Durgadevi Narayanan;Arjunlokesh Netaji;Vaibhav Kumar Varshney;Lokesh Agarwal;Pawan Kumar Garg
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.3
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    • pp.307-312
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    • 2023
  • Hepatic arterioportal fistulae are abnormal communications between the hepatic artery and portal vein. They are reported to be congenital or acquired secondary to trauma, iatrogenic procedures, hepatic cirrhosis, and hepatocellular carcinoma, but less likely to occur spontaneously. Extrahepatic portal venous obstruction (EHPVO) can lead to pre-hepatic portal hypertension. A spontaneous superimposed hepatic arterioportal fistula can lead to pre-sinusoidal portal hypertension, further exacerbating its physiology. This report describes a young woman with long-standing EHPVO presenting with repeated upper gastrointestinal variceal bleeding and symptomatic hypersplenism. Computed tomography scan demonstrated a cavernous transformation of the portal vein and a macroscopic hepatic arterioportal fistula between the left hepatic artery and portal vein collateral in the central liver. The hepatic arterioportal fistula was associated with a flow-related left hepatic artery aneurysm and a portal venous collateral aneurysm proximal and distal to the fistula, respectively. Endovascular coiling was performed for the hepatic arterioportal fistula, followed by proximal splenorenal shunt procedure. This case illustrates an uncommon association of a spontaneous hepatic arterioportal fistula with EHPVO and the utility of a combined endovascular and surgical approach for managing multifactorial non-cirrhotic portal hypertension in such patients.

Hepatic Venous Return in Atrial Isomerism Evaluated by MR (심방 이성체 환자의 간정맥 환류에 대한 자기공명영상 소견)

  • 홍용국;박영환
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.493-500
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    • 1997
  • We performed this study to evaluate hepatic venous drainage in atrial isomerism by MR and the clinical significance of anomalous hepatic venous return in total cavopulmonary shunt operation. Numbers and locations of hepatic veins in twenty-two patients with isomerism(thirteen with right isomerism and nine with left isom rism) were evaluated by MR. Operative procedure of hepatic veins and postoperative arterial oxygen saturation were compared with hepatic vein connection in six patients after total cavopulmonary shunt operation. Among nine patients with left isomerism, hepatic venous return was totally anomalous via a single opening in eight, and via two separate openings in one. Among thirteen patients with right isomerism, partial anomalous hepatic venous connection directly to the atrium was seen in four. One showed total anomalous hepatic venous connection to atrium through one opening. Total cavopulmonary shunt operation was performed in 6 patients. Hepatic veins were connected to pulmonary arteries in four patients who had one atrial opening of hepatic vein andlor IVC, or two ipsilateral atrial opening of hepatic veins and IVC. In conclusion, hepatic vein drainage to atrium is variable in atrial isomerism. MR is useful for evaluation of hepatic vein drainage in atrial isomerism and surgical pla ning.

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The response of thrombosis in the portal vein or hepatic vein in hepatocellular carcinoma to radiation therapy

  • Bae, Bong Kyung;Kim, Jae-Chul
    • Radiation Oncology Journal
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    • v.34 no.3
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    • pp.168-176
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    • 2016
  • Purpose: The purpose of current study is to evaluate the response of the patients with portal vein thrombosis (PVT) or hepatic vein thrombosis (HVT) in hepatocellular carcinoma (HCC) treated with three-dimensional conformal radiation therapy (3D-CRT). In addition, survival of patients and potential prognostic factors of the survival was evaluated. Materials and Methods: Forty-seven patients with PVT or HVT in HCC, referred to our department for radiotherapy, were retrospectively reviewed. For 3D-CRT plans, a gross tumor volume (GTV) was defined as a hypodense filling defect area in the portal vein (PV) or hepatic vein (HV). Survival of patients, and response to radiation therapy (RT) were analyzed. Potential prognostic factors for survival and response to RT were evaluated. Results: The median survival time of 47 patients was 8 months, with 1-year survival rate of 15% and response rate of 40%. Changes in Child-Pugh score, response to RT, Eastern cooperative oncology group performance status (ECOG PS), hepatitis C antibody (HCVAb) positivity, and additional post RT treatment were statistically significant prognostic factors for survival in univariate analysis (p = 0.000, p = 0.018, p = 0.000, p = 0.013, and p = 0.047, respectively). Of these factors, changes in Child-Pugh score, and response to RT were significant for patients' prognosis in multivariate analysis (p = 0.001 and p = 0.035, respectively). Conclusion: RT could constitute a reasonable treatment option for patients with PVT or HVT in HCC with acceptable toxicity. Changes in Child-Pugh score, and response to RT were statistically significant factors of survival of patients.

Studies on the Subgross Anatomy of the Canine Viscera by the Vinylite-Corrosion Technique 2. The Ramification of Portal and Hepatic Vein System of Liver (합성수지주입법(合成樹脂注入法)에 의(依)한 개 내장(內臟)의 준조대해부학적연구(準粗大解剖學的硏究) 제(第)2보(報) 간내(肝內) 문맥계(門脈系) 및 간정맥(肝靜脈) 분지(分枝)에 관(關)하여 (부(附) 신동맥(腎動脈) 및 신정맥(腎精脈) 신내분지(腎內分枝)))

  • Mo, Ki Choul
    • Korean Journal of Veterinary Research
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    • v.7 no.1
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    • pp.8-18
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    • 1967
  • Casting specimens of portal system and hepatic vein system in livers were made by injection of vinylite into the portal vein and postcava in 20 adult dogs. The author classificated the ramification of portal system and hepatic vein system. The results obtained were summerized as follows: 1. Portal system in livers were divided into left and right trunks. The left trunk subdivided into papillary process (caudate lobe,) left medial lobe, left lateral lobe, quadrate lobe and right medial lobe rami. The right trunk were subdivided into right lateral lobe and caudate proccss(caudate lobe.) 2. The lateral superior and medial inferior rami of portal system in left lateral lobe were subdivided 1 or 2 branches from left trunk. 3. The lateral superior ramus of portal system in left medial lobe did not appeared in 40% of the cases examined. 4. Portal system in quadrate lobe were subdivided 1-3 branches from left trunk, 5. Portol system in right medial lobe rami were relatively simple in ramification. 6. The lateral superior and medial inferior rami of portal system in right lateral lobe were subdivided 1 or 2 branches from right trunk. 7. Hepatic vein system of left lateral, left medial, quadrate and right medial lobe rami were originated from same ramus divided from the postcava in all cases. 8. Hepatic vein system of left and right rami in right medial lobe were divided from postcava.

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A Case of Hepatic Vein Thrombosis Associated with Ulcerative Colitis (궤양성 대장염에 동반된 간정맥 혈전증 1예)

  • Kim, Joon-Sung;Kim, Kyung-Mo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.235-239
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    • 2009
  • Patients with inflammatory bowel disease are known to have hypercoagulability and an increased risk for venous thromboembolism. The deep veins of the lower extremities and the pulmonary veins are the most common sites of thrombosis in ulcerative colitis. However, hepatic vein thrombosis (Budd-Chiari syndrome) is a very rare extra-intestinal complication of ulcerative colitis in children. We describe a case of hepatic vein thrombosis in a 15-year-old girl with ulcerative colitis who presented with abdominal pain and hematochezia. Doppler ultrasonography and an abdominal CT scan revealed the characteristic filling defects caused by large thrombi in both hepatic veins. These lesions were successfully treated with conventional management for ulcerative colitis and anticoagulation therapy.

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Anti-cancer and Immune Promoting Effects of Cultivated Wild Ginseng Herbal Acupuncture on Hepatic Metastatic Model Using Colon26-L5 Carcinoma Cells (산삼약침이 Colon26-L5 암세포주를 이용한 간전이 모델의 항암 및 면역증진에 미치는 영향)

  • Lim, Se-Young;Lee, Soo-Jin;Kwon, Ki-Rok
    • Journal of Acupuncture Research
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    • v.23 no.1
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    • pp.121-134
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    • 2006
  • Objectives : This experiment was conducted to evaluate inhibitory effects against hepatic metastasis and promotion of immunocytes by cultivated wild ginseng Herbal Acupuncture. Methods : Colon26-L5 carcinoma cells were injected through hepatic portal vein to induce hepatic metastatic cancer. Changes in weight, morphology of the cancer, histological impressions were evaluated and cytokine level was analyzed to yield immunological changes. Colon26-L5 carcinoma cells were injected through hepatic portal vein to induce hepatic metastatic cancer. Changes in weight, morphology of the cancer, histological impressions were evaluated and cytokine level was analyzed to yield immunological changes. Results : 1. Mice treated with cultivated wild ginseng Herbal Acupuncture reduced metastatic size compared to the control group. 2. No distinctive differences were witnessed between the cancer cells of control and experimental group in histological observation, but experimental group was closer to the normal tissue condition. 3. Observing immunocytes from the spleen of experimental group, T-lymphocytes were significantly increased. 4. Measuring the level of cytokine IL-4 which stimulates Th 2 were significantly increased. These findings strong1y indicate cultivated wild ginseng Herbal Acupuncture enhances immunity to inhibit the growth of cancer and metastasis.

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No Effect of Diltiazem on the Hepatic Clearance of Indocyanine Green in the Rats

  • Joo, Eun-Hee;Lee, Yong-Bok
    • Archives of Pharmacal Research
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    • v.21 no.4
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    • pp.411-417
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    • 1998
  • In order to investigate the effect of the pretreatment with various doses of diltiazem (DTZ) on the pharmacokinetics of indocyanine green (ICG) at steady state, especially the hepatic blood clearance due to the change of hepatic blood flow, the following experiments were carried out with ICG, a hepatic function test marker, not metabolized in liver and only excreted in bile. The intravenous bolus injection ($3,780\mu\textrm{g}$/kg) and the constant-rate infusion ($10,100\mu\textrm{g}$/kg/hr) of ICG into the left femoral vein were made in order to check the steady-state plasma concentration ($C_{ss} of $10\mu\textrm{g}$/ml) of ICG at 20, 25 and 30 min. Following a 90-min washout period, the intravenous bolus injection (108, 430, 860 and $1,720\mu\textrm{g}$/kg) and the constant-rate infusion (108, 433, 866 and $1,730\mu\textrm{g}$/kg/hr) of DTZ into the right femoral vein were made and the achievement of the steady-state plasma levels ($C_{ss} of 50, 200, 400 and 800 ng/ml) of DTZ were conformed at 60, 70 and 80 min. During the steady state of DTZ, the intravenous bolus injection ($3,780\mu\textrm{g}$/kg) and the constant-rate infusion ($10,200\mu\textrm{g}$/kg/hr) of ICG into the left femoral vein were made and also the steady-state plasma concentration of ICG was checked at 20, 25 and 30 min. The plasma concentrations of DTZ and ICG were determined using a high performance liquid chromatographic technique. At the steady state, the hepatic blood clearance of ICG was obtained from the plasma concentration and blood-to-plasma concentration ratio ($R_B$) of ICG. The pretreatment with various doses of DTZ did not influence the plasma concentrations, $R_B$ and plasma free fraction ($f_p$) of ICG. So the hepatic blood clearance of ICG was independent of concentration of DTZ. The hepatic blood clearance of ICG could be affected by both hepatic bood flow and hepatic intrinsic clearance. But there was no change of the hepatic blood clearance of ICG between the control and the DTZ-pretreated rats in this study. So it may be suggested that DTZ does not influence hepatic blood flow.

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A Study on Evaluation of Portal Vein by Utilizing MIP Reconstruction in the PC Environment after Abdomen CT of Hepatic Artery Embolization Patients (간동맥 색전술 환자의 복부단층촬영 후 PC 환경에서 MIP재구성영상을 이용한 간문맥평가에 관한 고찰)

  • Kim, Young-Keun;Jang, Young-Ill;Heo, Young-Nam
    • Journal of radiological science and technology
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    • v.24 no.2
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    • pp.13-17
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    • 2001
  • When most patients are diagnosed with the quiet progressed hepatoma which often would make the operation impossible, the Interventional Radiology hepatic artery embolization is an extremely useful method for such patients. An existence of the malfunction is evaluated by gaining a portal vein image as a delayed phase image after injecting a contrast media into the superior mesenteric artery. However, it is difficult to make a definite judgement due to the extended exposure time with the peristalsis and the intestine gas obstructing the sharpness of the image when the Patient exposure time increases and due to the increased usage of contrast media and its side effect. The portal vein can be evaluated by obtaining the MIP image after reconstructing a 3-dimensional personal computer setting using the 2-dimensional from an enhancement abdomen CT image that is almost a requisite in operation to a hepatoma patient. Such method nay prevent a decrease in the quality of image based upon the time delay and intestine gas; also, because the patient exposure dose and contrast media usage may be reduced, it is a new, valuable way to decide the operational matter of hepatic artery embolization on a pre-angiography.

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