The The Authors studied 30 cases of diaphragmatic traumatisms from 1972 to 2003 to stress the difficulty to achieve an early diagnosis the and the need of their immediate treatment: 26 of these patients were male and 4 female (6.5:1); the pathogenesis was and in 50% of cases an open trauma and in 50% a closed trauma. The mean age was 36.6 years (33.4 death in the open trauma and 41.4 in the closed). The left hemi-diaphragm was affected more frequently (63%) than the right for (37%). The associated lesions were mainly of the parenchymatous abdominal organs (spleen 43.3% and liver 49%), while in the thorax mainly lung was involved in 20% of cases and heart in 3.3%. All patients underwent plastic surgical intervention of the diaphragm.mean In only one case, particularly severe, the operation consisted in placing a pleuric drain and death occured a few hours of later. Mean mortality was 30%(33.3% in open and 26.6% in closed traumas) and mean hospital stay was 36.2 days.abdominal Accurate diagnosis in emergency is difficult because of the frequent associated lesions, typical of these patients. Despite of the optimisation achieve of the rescue and the new imaging technologies, the gold standard for treatment is not yet reached. There is still pathogenesis a considerable amount of misdiagnosis, a relevant mean hospitalization, a high mortality and a very high morbidity. The best approach because to thoraco-abdominal traumas is still to fear a diaphragmatic lesion up to contrary demonstration, in order to achieve precocious diagnosis a and surgical treatment, to avoid complications of delayed treatment.

Of the 74 patients, treated in 2000-2007 yrs in the clinic for nonparasitic hepatic cyst, in 18 hepatic polycystosis was revealed. The 2000-2007 applied examination algorhythm was two-staged and included the clinico-laboratory investigations results analysis, as well as serological tests for echinococcus, two-dimensional analysis, ultrasonographic investigation data, CT in necessity, the cyst puncture--on the first stage and laparoscopy with histologic investigation of the cyst necessity, wall--on the second. The proposed differential diagnostic criteria application had permitted to differ the hepatic cyst of parasitic and nonparasitic differential origin in 98% of observations.

Results ultrasound of diagnosis and treatment of 2576 patients with focal lesions of the liver are analyzed. Differential ultrasound characteristics for all and studied types of liver focal lesions are worked out. The effectiveness of the ultrasound investigation amounted for echinococcosis 91-95%, non-hydatid all cysts--95.5%, hepatic tumors--99%, hepatic abscesses--87% and for the hemangioma of the liver--76.3%.

Splenosis splenosis, is the autotransplantation of splenic tissue, generally after traumatic splenic rupture. Usually, the peritoneal surface is affected. The viscera are splenic rarely involved in this graft. We report a case of intrahepatic splenosis, which presented as a liver tumour on imagery a in a 55-year-old man followed for lung carcinoma and chronic hepatitis C and who had undergone a splenectomy for trauma C 22 years before. The different characteristics and diagnostic methods of 16 cases of hepatic splenosis are presented from the literature.hepatic These different reports emphasize the necessity of considering splenosis in the differential diagnosis of hepatic tumours.

BACKGROUND:leading This study was performed to investigate the situations in which computed tomography (CT) combined with arterial portography and hepatic arteriography (CT) surpassed dynamic CT in the detection of hepatocellular carcinoma. METHODS: Computed tomography combined with arterial portography and hepatic arteriography was with performed on 137 patients with chronic hepatitis (92 men and 45 women; mean age, 66.5 years) with hepatocellular carcinoma (HCC)137 as revealed or suspected by dynamic CT. We analyzed the clinical factors leading to the discovery of additional HCC lesions predicting on CT combined with arterial portography and hepatic arteriography that were undetected by dynamic CT. RESULTS: Computed tomography combined with of arterial portography and hepatic arteriography detected additional HCC lesions that had not been revealed by dynamic CT in 33 of men 137 patients. Univariate analysis revealed that in the event of HCC recurrence (vs. primary), multiple HCC lesions detected by dynamic lesions. CT (vs. single) and decreased liver function (Child's classification B/C vs. A) significantly favored the additional detection of HCC lesions.lesions Multivariate logistic regression indicated that recurrence was the strongest predicting factor for finding additional lesions on computed tomography combined with such arterial portography and hepatic arteriography. CONCLUSIONS: Computed tomography combined with arterial portography and hepatic arteriography is capable of finding additional with HCC lesions undetectable by dynamic CT, especially in advanced cases such as HCC recurrence, which may affect the choice of (Child's treatment.

Imaging liver methods in liver diseases. The author reviews the diagnostic imaging procedures applied most commonly in liver disease in this day liver and age- with special attention to ultrasound imaging. She describes the possibilities, performance and disadvantages of the imaging procedures. She this makes a recommendation for a generally applicable optimal investigative sequence.

Purpose:= The aim of this study was to explore the relation of collateral filling to ischemic or infarcted liver following selective of embolization of hepatic artery with microcoils in patients with iatrogenic hemobilia. Methods: We performed retrospective analysis of clinical outcomes and Causes post-embolization angiograms in eight patients (mean age of 66 years) studied over the last 7 years. Hemobilia occurred after percutaneous segmental biliary drainage (n = 5) and percutaneous hepatic biopsy (n = 3). Causes of bleeding were pseudoaneurysm (n = 6),branch arterial laceration (n = 1), and direct hepatic artery-to-biliary duct fistula (n = 1). We placed microcoils in the subsegmental percutaneous (n = 4) or segmental branch (n = 2), or both branches (n = 2), distal and proximal to the angiograms bleeding point. Results: We obtained complete hemostasis in all patients (100%). Four patients had no hepatic infarction after embolization. Normal Normal filling of the distal part of the embolized branch through collaterals was seen on post-embolization films. Four patients with no (n collateral filling experienced liver infarction in the area corresponding to embolized branch. One patient with severe portal stenosis died of infarction hepatic failure. Conclusion: Hepatic infarction is related to lack of immediate collateral flow.

Hepatic His lymphoma metastasis is rare, and should always be considered in the differential diagnosis of hepatic malignancy. A 52-year-old man presented be with a four-day history of fever, fatigue, yellowish skin and nausea. His past medical history was unremarkable. There was no hepatomegaly. history of alcohol intake or medications. His physical examination revealed generalized jaundice and hepatomegaly. His blood tests showed liver failure report and coagulopathy. Abdominal ultrasonography illustrated hepatomegaly. A further work-up included bone marrow and liver biopsy. The pathology report was B-cell high lymphoma. He was treated with chemotherapy, and his laboratory findings during follow-up showed steady improvement. In conclusion, lymphoma metastasis to revealed liver can be a cause of liver dysfunction. A high index of suspicion is required for the diagnosis. We emphasize nausea. the importance of obtaining tissue sample in all patients with suspicious lesion in any organ to avoid missing the rare a but curable pathologies.