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Multiple infarcted regenerative nodules in liver cirrhosis after decompensation of cirrhosis: a case series

INTRODUCTION: Liver cirrhosis is a common disease with many known complications. Cirrhosis represents a clinical spectrum, ranging from asymptomatic liver disease to hepatic decompensation. Manifestations of hepatic decompensation include variceal bleeding, ascites, hepatic encephalopathy, hepatoren...

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Autores principales: Scholtze, Dieter, Reineke, Tanja, Müllhaupt, Beat, Gubler, Christoph
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003675/
https://www.ncbi.nlm.nih.gov/pubmed/21092254
http://dx.doi.org/10.1186/1752-1947-4-375
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author Scholtze, Dieter
Reineke, Tanja
Müllhaupt, Beat
Gubler, Christoph
author_facet Scholtze, Dieter
Reineke, Tanja
Müllhaupt, Beat
Gubler, Christoph
author_sort Scholtze, Dieter
collection PubMed
description INTRODUCTION: Liver cirrhosis is a common disease with many known complications. Cirrhosis represents a clinical spectrum, ranging from asymptomatic liver disease to hepatic decompensation. Manifestations of hepatic decompensation include variceal bleeding, ascites, hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, portopulmonary hypertension and hepatocellular carcinoma. There are reports about infarcted regenerative nodules in cirrhotic livers after gastrointestinal hemorrhage. CASE PRESENTATION: We report three Caucasian patients (one female and two male patients; ages: 52, 54 and 60 years) with decompensated liver cirrhosis, who showed newly infarcted regenerative nodules at necropsy. Two of them suffered from gastric variceal bleeding. Histopathology showed extensive infarction in all three cases. Hemorrhage and inflammatory changes were also observed around the infarcted regenerative nodules. CONCLUSION: These patients showed focal liver lesions, to be considered in the differential diagnosis of cirrhotic livers. Infarcted regenerative nodules may be underdiagnosed in patients with decompensation of cirrhosis. In order to differentiate these lesions from malignant tumors, serial imaging seems to be helpful. However, the main differential diagnosis should be an abscess. It is important to know the wide spectrum of image appearances of these lesions. Hypotension can lead to a reduction of portal and arterial liver flow. Since variceal bleeding or septic shock can induce hypotension - as observed in our patients - we conclude that this leads to infarction of such nodules.
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spelling pubmed-30036752010-12-18 Multiple infarcted regenerative nodules in liver cirrhosis after decompensation of cirrhosis: a case series Scholtze, Dieter Reineke, Tanja Müllhaupt, Beat Gubler, Christoph J Med Case Reports Case Report INTRODUCTION: Liver cirrhosis is a common disease with many known complications. Cirrhosis represents a clinical spectrum, ranging from asymptomatic liver disease to hepatic decompensation. Manifestations of hepatic decompensation include variceal bleeding, ascites, hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, portopulmonary hypertension and hepatocellular carcinoma. There are reports about infarcted regenerative nodules in cirrhotic livers after gastrointestinal hemorrhage. CASE PRESENTATION: We report three Caucasian patients (one female and two male patients; ages: 52, 54 and 60 years) with decompensated liver cirrhosis, who showed newly infarcted regenerative nodules at necropsy. Two of them suffered from gastric variceal bleeding. Histopathology showed extensive infarction in all three cases. Hemorrhage and inflammatory changes were also observed around the infarcted regenerative nodules. CONCLUSION: These patients showed focal liver lesions, to be considered in the differential diagnosis of cirrhotic livers. Infarcted regenerative nodules may be underdiagnosed in patients with decompensation of cirrhosis. In order to differentiate these lesions from malignant tumors, serial imaging seems to be helpful. However, the main differential diagnosis should be an abscess. It is important to know the wide spectrum of image appearances of these lesions. Hypotension can lead to a reduction of portal and arterial liver flow. Since variceal bleeding or septic shock can induce hypotension - as observed in our patients - we conclude that this leads to infarction of such nodules. BioMed Central 2010-11-23 /pmc/articles/PMC3003675/ /pubmed/21092254 http://dx.doi.org/10.1186/1752-1947-4-375 Text en Copyright ©2010 Scholtze et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<url>http://creativecommons.org/licenses/by/2.0</url>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Scholtze, Dieter
Reineke, Tanja
Müllhaupt, Beat
Gubler, Christoph
Multiple infarcted regenerative nodules in liver cirrhosis after decompensation of cirrhosis: a case series
title Multiple infarcted regenerative nodules in liver cirrhosis after decompensation of cirrhosis: a case series
title_full Multiple infarcted regenerative nodules in liver cirrhosis after decompensation of cirrhosis: a case series
title_fullStr Multiple infarcted regenerative nodules in liver cirrhosis after decompensation of cirrhosis: a case series
title_full_unstemmed Multiple infarcted regenerative nodules in liver cirrhosis after decompensation of cirrhosis: a case series
title_short Multiple infarcted regenerative nodules in liver cirrhosis after decompensation of cirrhosis: a case series
title_sort multiple infarcted regenerative nodules in liver cirrhosis after decompensation of cirrhosis: a case series
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003675/
https://www.ncbi.nlm.nih.gov/pubmed/21092254
http://dx.doi.org/10.1186/1752-1947-4-375
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