14 September 2023 : Case report
[In Press] Intrahepatic Venous Collateral Circulation and Reverse Blood Flow After Main Hepatic Vein Obstruction: A Case Report with Literature Review
Jianghong Ning1DE, Yibulayin Aini1BF, Tiemin Jiang1AG, Yingmei Shao12A, Tuerganaili Aji12AD, Hao Wen12CDDOI: 10.12659/AOT.941521
Ann Transplant In Press; DOI: 10.12659/AOT.941521
Available online: 2023-09-14, In Press, Corrected Proof
Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule
Abstract
BACKGROUND
Alveolar echinococcosis, a lethal parasitic disease, can invade important vessels in the liver. A liver vascular anomaly causes compensatory changes in other blood vessels connected to it because of the close relationship between them. Obstruction of the retrohepatic inferior vena cava and the second hilum can form the intrahepatic venous network and the vertebral venous plexus pathway, which can be demonstrated by hepatic venography and anatomical and autopsy studies.
CASE REPORT
A Tibetan woman, age 31, with hepatic alveolar echinococcosis and unique intrahepatic hemodynamic features, was referred to our center and underwent successful ex vivo liver resection and autotransplantation.
We report our experience and review the literature. In this clinical case, we performed an ex vivo liver resection and autotransplantation without hepatic inferior vena cava reconstruction. After surgery, the circulatory system hemodynamic remained stable, and blood flow in the liver and trunk was unhindered. The patient underwent an uneventful hospitalization and recovery.
CONCLUSIONS
This clinical case demonstrates the unique venous access, hemodynamic alterations, and surgical decision-making that follow the invasion of significant hepatic vessels by alveolar echinococcosis lesions. HAE exhibits unique collateral vessels, which are uncommon in other diseases. Additionally, this kind of therapy offers fresh perspectives for the surgical treatment of end-stage HAE.
Keywords: Collateral Circulation; Hemodynamics; Alveolar Echinococcosis
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