Monthly Archives: March 2013

Definition: trisegmentectomy

The hepatic trisegmentectomy resects lesions like hepatocellular carcinoma by removing the entire right lobe in continuity with most or all of the medial segment of the left lobe.  For those with advanced portal hypertension, or evidence of liver insufficiency (ie. … Continue reading

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Clinical Pearl

Bile duct ischemia has many causes, though we tend to think about it only in the liver transplant setting.  Remember to consider: hepatic artery chemotherapy infusion/embolization/chemoembolization, radiotherapy to the common bile duct, cholecystectomy, hereditary hemorrhagic teleangectasia, systemic vasculitis, AIDS and … Continue reading

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Quotation

You are never as smart as you think you are, nor are you ever as dumb as you think you are.   – Cohen

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Definition: chylous ascites

Chylous ascites has a white color (triglyceride-rich) and many potential causes including cirrhosis, pancreatitis, tuberculosis, right heart failure, lymphoma or thoracic trauma.  The triglyceride level should be above 200 mg/dL and it may help to compare the level in ascites … Continue reading

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Lecture: liver cysts

This lecture focused on the diagnosis and management of liver cysts.  The simple liver cyst is the second most common liver lesion behind the hemangioma.  A simple cyst requires no therapy and no follow up.  A complex cyst, however, is … Continue reading

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The Sunday Chronicles

Carnett’s Maneuver is particularly useful in your Olympic champion-type weightlifter (sens./spec. of 80-90%):  while 1600+ lbs. is hoisted to shoulder level (or higher), press firmly into the mid-abdomen and have him report pain levels on a 0-10 scale.

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Radiology: colonic dilation

Note in the radiograph above the extensive colonic dilation.  In the world of hepatology, colonic dilation might be seen with ileus from causes such as spontaneous bacterial peritonitis (or secondary peritonitis).  It might be seen in a post-operative setting, ie. … Continue reading

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