We report the case of a young trauma patient who needed tight perihepatic surgical packing to control bleeding from a ruptured liver. He developed severe cardiovascular and respiratory decompensation on removal of the surgical packs as a result of the post-reperfusion syndrome. He underwent a total hepatectomy and, 35 h later, orthotopic liver transplantation. The pathophysiology of post-reperf...

OBJECTIVE To document and analyse the presentation and outcome of surgical management of liver trauma. METHODS The study was a retrospective review of records of all surgeries carried out at the Department of General Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from January 2003 to December 2010. The study included all adult patients of either gender who presented with l...

OBJECTIVE To assess the value of magnetic resonance cholangiography with gadobenate dimeglumine (Gd-BOPTA) where there is a suspicion of bile leakage in the post-liver transplant patient. PATIENTS AND METHODS Eight patients who had undergone a liver transplant underwent 14 MR cholangiograms, five of whom presented bile leakage while the other three had no biliary system complications. The res...

A 45-year-old man was admitted for pain in the upper right abdominal quadrant that had been evolving for months. His previous medical history was unremarkable. The physical examination showed a painful and tense abdomen in the right hypochondrium but the rest was pain free. Biological analysis showed an inflammatory syndrome (C-reactive protein 29.54mg/L). Liver enzymology and urine and blood c...

In addition to hemorrhage, which is one of the most well-known factors, there are many other causative factors for serious hypotension after hepatic trauma. In this report, we present patients with persistent cardiac depression after perihepatic packing due to high grade liver injury and report on treatment modalities, including the early second-look procedure. Three patients with isolated hepa...

An 18-year-old womanwith superficial spreadingmelanoma in the epigastric region arising from a congenital nevus (Clark level III, Breslow thickness 3.56mm, mitotic rate 2mitoses/mm2), previously removed, was referred for a sentinel lymph node biopsy. After intradermal injection of 111MBq of 99mTc-nanocolloid (Nanocoll) around the excisional biopsy scar, lymphatic mapping was initiated. Dynamic ...

INTRODUCTION Hemangioma is the most frequent benign solid tumor of the liver. It is well known that a giant liver hemangioma carries the risk of spontaneous rupture, followed by hemoperitoneum and hemorrhagic shock with possible fatal outcome. CASE OUTLINE This is a case report of the spontaneous rupture of a giant cavernous hemangioma of the liver in an 85-year old patient.The patient was pr...

BACKGROUND With an increasing incidence of road traffic accidents and weapon injuries there is increasing need for improvement in trauma management. Liver being a highly vascular organ and strategically located is difficult to manage. METHODS Study was conducted in Surgical 'A' Unit, Lady Reading Hospital, Peshawar from August 2003 to September 2005. It was a descriptive study and all patient...