A woman presenting with an unusual cause of fulminant liver failure and sepsis - 27/03/22

Doi : 10.1016/j.clinre.2021.101836

Yannis K. Valtis ^a,^f,^⁎ , Trevor Barlowe ^a,^f, Jonathan H. Young ^b,^f, Andrew H. Lichtman ^b,^f, Lei Zhao ^b,^f, Jason L. Hornick ^b,^f, James M. Cleary ^c,^f, Nikroo Hashemi ^a,^f, Alan Cubre ^d,^f, Rebecca M. Baron ^a,^e,^f
^a Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
^b Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
^c Center of Gastrointestinal Oncology, Dana Farber Cancer Center, Boston, MA, USA
^d Department or Radiology, Brigham and Women's Hospital, Boston, MA, USA
^e Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, USA
^f Harvard Medical School, Boston, MA, USA

^⁎Corresponding author at: Yannis K. Valtis, M.D. Brigham and Women's Hospital, Medical Residency Office, 75 Francis St., Boston, MA 02115.Brigham and Women's Hospital, Medical Residency Office75 Francis St.BostonMA02115

Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.

Abbonarsi

pagine	7
Iconografia	4
Video	0
Altro	0

Abstract

We present the case of a 61-year-old woman who presented with acutely worsening right upper quadrant pain and was found to be in acute liver failure with Klebsiella pneumoniae bacteremia. Despite aggressive intensive care management, the patient ultimately died of refractory shock attributed to sepsis and fulminant liver failure. On autopsy, she was found unexpectedly to have diffuse intrahepatic cholangiocarcinoma with metastases to regional lymph nodes and intravascular spread to the lungs. The case highlights a rare instance where intrahepatic cholangiocarcinoma presents with acute liver failure and discusses key intensive care management principles of this clinical syndrome.

Il testo completo di questo articolo è disponibile in PDF.

Mappa

Introduction

Clinical scenario

Diagnostic discussion

Therapeutic approaches

Esportazione

Vol 46 - N° 3

Articolo 101836- Marzo 2022 Ritorno al numero

Articolo precedente

The efficacy of adjuvant N acetyl cysteine for the eradication of H pylori infections: A systematic review and meta-analysis of randomized clinical trials
Dr. Pritam Biswas, Dr. Sukumar TK

| Articolo seguente

A systemic mechanism of increased transendothelial migration of leukocytes through the blood-brain barrier in hepatic encephalopathy
Augustin Schaefer, Martin Journaux, Haquima El Mourabit, Sarah Mouri, Dominique Wendum, Elisabeth Lasnier, Pierre-Olivier Couraud, Chantal Housset, Dominique Thabut, Marika Rudler, Nicolas Weiss

Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.

Abbonarsi

Già abbonato a @@106933@@ rivista ?

connettersi o creare un account

A woman presenting with an unusual cause of fulminant liver failure and sepsis - 27/03/22

Abstract

Mappa

Citazioni Export

File

Contenuto

Il mio account

Aide & support

Dichiarazione CNIL