Temiz MZ, Yuruk E, Teberik K, Akbas BK, Piroglu MD, Oztorun HS, Kandirali E. Ischemic hepatitis after percutaneous nephrolitotomy: A case report.
Int J Surg Case Rep 2014;
5:1258-60. [PMID:
25437690 PMCID:
PMC4275824 DOI:
10.1016/j.ijscr.2014.10.087]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 10/24/2014] [Accepted: 10/24/2014] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION
Ischemic hepatitis (IH) is the necrosis of the centrilobular hepatocytes of liver and is secondary to liver hypoperfusion in most of the cases. The diagnosis is usually based on biochemical findings due to the absence of symptoms and signs. Although the disease course is often mild, and sometimes is even not diagnosed, the outcome is poor if the etiology of hypotension and liver anoxia is not promptly corrected.
PRESENTATION OF CASE
A 64-year-old patient who underwent percutaneous nephrolithotomy (PNL) for right renal pelvic stone developed acute IH at first postoperative day as a result of hemorrhage related severe hypotension. After restoring hemodynamic parameters, she completely recovered 2 weeks after the operation.
DISCUSSION
IH is a frequent cause of marked serum aminotransferase elevation and most commonly occurs as a result of arterial hypoxemia and insufficient hepatic perfusion. Although no specific treatment of IH exists, stabilizing the hemodynamic parameters of the patient resolves the problem in most of the cases.
CONCLUSION
This case is presented to demonstrate that ischemic hepatitis should be kept in mind if severe hemorrhage occurs during PNL.
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