Ultrasound The common bile duct

April 23, 2015 Posting Komentar

This should be carefully monitored postoperatively. A measurement serves as a baseline from which to detect small degrees of dilatation which may imply stenosis or obstruction. Even relatively minor dilatation can be significant in the transplant patient; cholestasis can precipitate ascending biliary infection which may subsequently form liver abscesses, a process which may be aggravated by immunosuppression.
Biliary complications occur in up to 15% of transplants and most biliary complications become evident during the first 3 months, although late stenosis can occur after this. Strictures commonly occur at the anastomosis due to scar tissue, but other, non-anastomotic strictures can result from hepatic artery insufficiency causing ischaemia. Leakage is a comparatively rare event.

Focal lesions

Focal lesions within the parenchyma of the transplant liver are usually a poor prognostic indicator. Hepatic abscesses may be multiple and are often acoustically subtle in the early stages, with echo patterns closely similar to normal liver tissue. Other causes of focal lesions in the early postoperative period may be due to infarction and are associated with interruption of the arterial supply. These can be hyper- or hypoechoic, have welldefined orders and do not exert a mass effect. The longer the interval between removing and transplanting the donor liver, the greater the likelihood f ischaemic patches forming. In patients who have been transplanted following cirrhosis with malignancy, recurrence of HCC may also be a serious complication. Post-transplant lymphoproliferative disorder may also demonstrate hypoechoic focal lesions within the liver, occasionally also involving the pleen and kidneys.