Failure of duplex sonography to diagnose hepatic artery thrombosis in a high-risk group of pediatric liver transplant recipients
| Autor: | Theodore R. Hall, Sue V. McDiarmid, Jorge Vargas, J F Lois, Ronald W. Busuttil, Edward Grant, Marvin E. Ament, Allen L. Milewicz, Kim M. Olthoff |
|---|---|
| Rok vydání: | 1991 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Liver transplantation Hepatic Artery Risk Factors medicine.artery medicine Humans Superior mesenteric artery Child False Negative Reactions Ultrasonography medicine.diagnostic_test Bile duct business.industry Thrombosis General Medicine medicine.disease Surgery Liver Transplantation Radiography medicine.anatomical_structure Duplex (building) Pediatrics Perinatology and Child Health Angiography Radiology Complication business Artery |
| Zdroj: | Journal of pediatric surgery. 26(6) |
| ISSN: | 0022-3468 |
| Popis: | Excellent correlation between angiographic findings and duplex sonography has been previously reported in the diagnosis of hepatic artery thrombosis (HAT), the most common technical complication of pediatric orthotopic liver transplantation (OLT). We now report a significant incidence of false-negative sonograms, ie, hepatic artery reported as patent but thrombosed on subsequent angiography. HAT was diagnosed in 10 of 57 pediatric OLT recipients evaluated prospectively by duplex sonography. In 5 patients HAT was diagnosed only by angiography even though arterial wave forms were observed on duplex sonography. Selective angiography demonstrated extensive collateral vessel formation arising from the superior mesenteric artery, the celiac axis, or both. The 5 patients shared very similar clinical courses marked by relapsing bacteremias with multiple enteric organisms, associated with focal infarctions of the liver. Four of the grafts had difficult arterial reconstructions and 3 of 5 had segmental bile duct dilation. We conclude that duplex sonography has proven to be a valuable screening tool in evaluating hepatic artery patency but must be correlated with angiography studies in a high-risk group of pediatric transplant patients characterized clinically by relapsing bacteremia and radiographically by false-negative duplex examinations. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|