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| 1 | Selective embolization for bleeding visceral artery pseudoaneurysms in patients with pancreatitis显示文摘BACKGROUND:Pancreatitis is associated with arterial complications in 4%-10%of patients,with untreated mortality approaching 90%.Timely intervention at a specialist center can reduce the mortality to 15%.We present a single institution experience of selective embolization as first line management of bleeding pseudoaneurysms in pancreatitis. METHODS:Sixteen patients with pancreatitis and visceral artery pseudoaneurysms were identified from searches of the records of interventional angiography from January 2000 to June 2007.True visceral artery aneurysms and pseudoaneurysms arising as a result of post-operative pancreatic or biliary leak were excluded from the study. RESULTS:In 50%of the patients,bleeding complicated the initial presentation of pancreatitis.Alcohol was the offending agent in 10 patients,gallstones in 3,trauma,drug-induced and idiopathic pancreatitis in one each.All 16 patients had a contrast CT scan and 15 underwent coeliac axis angiography. The pseudoaneurysms ranging from 0.9 to 9.0 cm affected the splenic artery in 7 patients:hepatic in 3,gastroduodenal and right gastric in 2 each,and left gastric and pancreatico-duodenal in 1 each.One patient developed spontaneous thrombosis of the pseudoaneurysm.Fourteen patients had effective coil embolization of the pseudoaneurysm.One patient needed surgical exclusion of the pseudoaneurysm following difficulty in accessing the coeliac axis radiologically.There were no episodes of re-bleeding and no in-hospital mortality. CONCLUSIONS:Pseudoaneurysms are unrelated to the severity of pancreatitis and major hemorrhage can occur irrespective of their size.Co-existent portal hypertension and sepsis increase the risk of surgery.Angiography and selective coil embolization is a safe and effective way to arrest the hemorrhage. | Harsheet Sethi Praveen Peddu Andreas Prachalias Pauline Kane John Karani Mohamed Rela Nigel Heaton | 2010 | Hepatobiliary & Pancreatic Diseases International2010，9，6： | 12 |
| 2 | Congenital extrahepatic portosystemic shunt complicated by the development of hepatocellular carcinoma显示文摘Congenital extrahepatic portosystemic shunt,also known as Abernethy malformation, is a rare congenital malformation. It causes shunting of blood through a communication between the portal and systemic veins such as a patent ductus venous. We report 3 cases of Abernethy malformation complicated by the development of hepatocellular carcinoma. Additionally, we comprehensively reviewed all previously reported cases and highlighted common features that may help in early diagnosis and appropriate management.Patients with Abernethy malformation may have an increased propensity to develop hepatocellular carcinoma. All 5 previously reported cases, plus the three of our patients, have a type 1(complete) shunt suggesting a role for absent portal blood flow in the pathogenesis of hepatocellular carcinoma. Congenital extrahepatic portosystemic shunt should be sought for in cases with raised serum ammonia, hepatic encephalopathy or hepatocellular carcinoma in the absence of cirrhosis. | Ruchi Sharma Abid Suddle Alberto Quaglia Praveen Peddu John Karani Thomas Satyadas | 2015 | Hepatobiliary & Pancreatic Diseases International2015，14，5： | 7 |
| 3 | Liver resection for the treatment of a congenital intrahepatic portosystemic venous shunt显示文摘Intrahepatic portosystemic shunts(IPSS) are rare congenital anomalies arising from disordered portal vein embryogenesis.It has been described in both children and adults and may be asymptomatic or be associated with a variety of neurophysiological and pulmonary complications.When recognized,early intervention to occlude the shunt will reverse the associated complications.Literature review reports of surgical and radiological occlusion of the shunt,but due to its rarity,a standard therapeutic protocol has not been established.A case of a 38-year-old woman with abdominal pain and low grade encephalopathy,diagnosed with an IPSS and treated by right hepatectomy was reported. | michail papamichail amir ali alberto quaglia john karani nigel heaton | 2016 | Hepatobiliary & Pancreatic Diseases International2016，15，3： | 2 |
| 4 | Chronic Mesenteric Venous Thrombosis: Evaluation and Determinants of Survival During Long-Term Follow-up显示文摘 | David W. Orr Phillip M. Harrison John Devlin John B. Karani Pauline A. Kane Nigel D. Heaton John G. O’Grady Michael A. Heneghan | 2007 | Clinical Gastroenterology and Hepatology2007，，1： | 1 |
| 5 | Autoimmune hepatitis/sclerosing cholangitis overlap syndrome in childhood: A 16-year prospective study显示文摘 | Germana V. Gregorio Bernard Portmann John Karani Phil Harrison Peter T. Donaldson Diego Vergani Giorgina Mieli-Vergani | 2001 | Hepatology2001，，： | 1 |
| 6 | Autoimmune hepatitis/sclerosing cholangitis overlap syndrome in childhood: A 16-year prospective study显示文摘 | Germana V. Gregorio Bernard Portmann John Karani Phil Harrison Peter T. Donaldson Diego Vergani Giorgina Mieli-Vergani | 2001 | Hepatology2001，，3： | 1 |
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