Transarterial embolization with bleomycin-lipiodol emulsion: a successful minimal invasive approach for giant liver hemangioma

Hemangiomas are most common benign liver tumor. Most patients have an excellent prognosis because of the small size and benign nature of tumor. On some occasions, giant liver hemangioma may cause symptoms and significant challenges due to its complication. We report a case of giant liver hemangioma treated with minimal invasive approach by transarterial embolization (TAE). Following three TAE sessions over a specific timeframe, the patient was successfully managed, addressing that TAE may be a useful alternative to hepatic surgery in such cases.

Insulin Use and The Risk of Hepatocellular Carcinoma: Insights and Implications

In recent years, the incidence of diabetes mellitus and hepatocellular carcinoma (HCC) has been increasing worldwide, in the context of an increasing prevalence of non-alcoholic fatty liver disease (NAFLD). In patients with diabetes mellitus, exogenous insulin is commonly prescribed and used in long-term settings. Recent studies suggest that insulin use may elevate the risk of HCC. A substantial body of work seeks to unpack the association between insulin use and the risk of developing HCC, although there may be conflicting evidence. Further validation is necessary to clarify the true relationship between insulin mechanisms and its hepatocarcinogenic effect. Given the burden of diabetic patients developing HCC, diabetologists and hepatologists must collaborate, particularly regarding the prevention and surveillance of HCC in diabetic patients.

Expanded hemodialysis: a new concept of renal replacement therapy

Expanded hemodialysis (HDx) is an innovation that can increase the effectiveness of hemodialysis. The dialysis process is expected to promote more uremic toxins removal without causing significant hypoalbuminemia using the medium cut-off (MCO) membrane or also known as the high retention onset membrane. Compared with conventional membranes such as those of low-flux hemodialysis, high-flux hemodialysis, and hemodiafiltration, the MCO membrane in HDx is considered to be the closest to the physiology of the glomerular membrane. Several studies have shown the use of the MCO membrane in HDx provides clinical benefits and better outcome although further studies are needed to assess the long-term effect and greater impact for dialysis patients.

Multiple Retroperitoneal Abscesses Caused by Extended-Spectrum β-Lactamase-Producing Escherichia coli: A Case Report

Diagnosis, and management of retroperitoneal abscesses caused by ESBL (Extended-Spectrum-β-Lactamase) Escherichia Coli require special attention. A female patient came to the Emergency Department with complaints of abdominal discomfort, bloating, nausea, fever, and urination pain for 1 week, and a physical examination demonstrated an enlarged mass in the left flank for the past 6 months. Laboratory results showed an increase in leukocytes and procalcitonin; hence the antibiotic cefoperazone sulbactam was given as empirical therapy. An abdominal CT scan revealed multiple retroperitoneal abscesses in the left and right hemiabdomen; therefore, levofloxacin and metronidazole were given as additional antibiotics. Percutaneous abscess drainage was performed and from the pus culture obtained grew ESBL Escherichia Coli bacteria. Furthermore, antibiotics were changed to intravenous amikacin according to the results of the susceptibility test. The patient's clinical symptoms improved significantly, and she was discharged and evaluated in the outpatient clinic.