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Cureus 2021 May 6;13(5):e14880. Epub 2021 May 6.

Department of Medicine, Lady Hardinge Medical College, Delhi, IND.

Immune hemolytic anemia is very rarely associated with chronic liver disease. Diagnosis is often complicated in critically ill patients, where an etiological diagnosis can be elusive, especially in routine health care settings. A 48-year-old man presented with jaundice for three months. Read More

J Vasc Interv Radiol 2021 May 28. Epub 2021 May 28.

Division of Vascular & Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, NC 27710. Electronic address:

Purpose: To report initial clinical experience with intravascular ultrasound guided transvenous biopsy (IVUS-TVB) for perivascular target lesions in the abdomen and pelvis using side-viewing phased array intracardiac echocardiography catheters.

Materials And Methods: In this single institution, retrospective study 50 IVUS-TVB procedures were performed in 48 patients for targets close to the inferior vena cava or iliac veins deemed difficult to access by conventional percutaneous needle biopsy (PNB). In all procedures side-viewing phased array intracardiac echocardiography IVUS catheters and transjugular liver biopsy sets were inserted through separate jugular or femoral vein access sheaths, and 18-gauge core needle biopsy specimens were obtained under real-time IVUS guidance. Read More

Cancer Treat Res Commun 2021 May 13;28:100388. Epub 2021 May 13.

Department of Gastroenterology, Kikuna Memorial Hospital, Yokohama, Kanagawa, Japan.

In the present study, we aimed to clarify features of carcinomatous cirrhosis from breast cancer presenting as refractory transudate ascites and acute liver failure. In our systematic literature review, we identified 26 studies and 31 cases including our case of this rare condition. Our patient was a 49-year-old woman with a history of ascites and liver failure for the past 4 years and currently being treated for invasive ductal breast cancer. Read More

Clin Transl Gastroenterol 2021 May 21;12(5):e00355. Epub 2021 May 21.

Dumont-UCLA Transplant Center, Pfleger Liver Institute, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, USA.

Introduction: The purpose of this study was to investigate the rates of complications and diagnostic yield of transjugular liver biopsy (TJLB) in deceased donor liver transplant (DDLT) recipients.

Methods: From January 2009 to December 2019, 1,055 TJLBs were performed in 603 adult DDLT recipients with a mean age of 54 (±12 years). Data were retrospectively reviewed to determine the diagnostic efficacy and incidence of major and minor complications in the 3-day and 1-month period after TJLB. Read More

Gastroenterology Res 2021 Apr 21;14(2):129-137. Epub 2021 Apr 21.

Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA.

Hepatic steatosis is common in everyday liver pathology practice. There are many etiologies leading to hepatic steatosis. These etiologies include metabolic syndrome, alcohol, medications, monogenetic disease, infectious diseases, and malnutrition. Read More

Biomed Res Int 2021 17;2021:5530004. Epub 2021 Apr 17.

Department of Ultrasonic Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China 710032.

Objectives: To investigate the performance of spleen stiffness (SS) by using two-dimensional shear-wave elastography (2D-SWE) for assessing the severity of gastroesophageal varices (GEVs) after transjugular intrahepatic portosystemic shunt (TIPS).

Methods: 102 eligible patients were categorized as in the post-TIPS short-term ( = 69) and long-term ( = 38) follow-up groups. The performance of SS by using 2D-SWE for evaluating the severity of GEVs was compared with liver stiffness (LS), spleen stiffness-to-liver stiffness ratio (SS/LS), liver stiffness spleen-diameter-to-platelet-ratio score (LSPS), portal hypertension (PH) risk score, platelet count-to-spleen diameter ratio (PSR), and varices risk score by using receiver operating characteristic (ROC) curve and DeLong test. Read More

J Clin Imaging Sci 2021 26;11:25. Epub 2021 Apr 26.

Department of Radiology, NorthShore University Health Sciences, Evanston, Illinois, United States.

Objectives: Measurement of hepatic vein pressures is the accepted gold standard for the evaluation of portal hypertension. This study was conducted to evaluate the correlation between hepatic vein pressure measurements and histologic findings from transjugular liver biopsies. The hypothesis was that higher hepatic venous pressure gradients would correlate with a histologic diagnosis of cirrhosis. Read More

Rev Esp Enferm Dig 2021 May 5. Epub 2021 May 5.

Gastroenterology, Suzhou Ninth People's Hospital, China.

A 46-year-old female patient was admitted to our hospital with abdominal distension and fatigue for 1 months. Physical examination revealed several lymph nodes were palpable in bilateral axilla and groin, ranging from 0.5cm to 2. Read More

Int J Surg Case Rep 2021 May 7;82:105852. Epub 2021 Apr 7.

Donald Gordon Medical Centre, University of the Witwatersrand, South Africa. Electronic address:

Introduction And Importance: Variceal bleeding due to intrahepatic arterioportal fistula is an unusual complication of percutaneous liver biopsy. As majority of variceal bleeding are cirrhotic in origin, the rare occurrence of an acquired intrahepatic arterioportal fistula presents a therapeutic dilemma.

Case Presentation: We report the case of a 57-year-old female with refractory variceal bleeding that occurred six years after a percutaneous liver biopsy. Read More

Liver Transpl 2021 Apr 14. Epub 2021 Apr 14.

Hospital of the University of Pennsylvania, Department of Surgery, Philadelphia, PA, USA.

Introduction: Transplant eligibility for hepatocellular carcinoma (HCC) is determined by the imaging identification of tumor burden within Milan criteria. Transjugular intrahepatic portosystemic shunts (TIPS) reduce portal hypertension but may impact HCC visualization. It was hypothesized that the presence of pre-transplant TIPS would correlate with occult HCC and reduced survival. Read More

J Vasc Interv Radiol 2021 05 27;32(5):672-676. Epub 2021 Mar 27.

Department of Interventional Radiology, Stanford University School of Medicine, Stanford, California, United States. Electronic address:

Purpose: To analyze the impact of physician-specific equipment preference on cost variation for procedures typically performed by interventional radiologists at a tertiary care academic hospital.

Materials And Methods: From October 2017 to October 2019, data on all expendable items used by 9 interventional radiologists for 11 common interventional radiology procedure categories were compiled from the hospital analytics system. This search yielded a final dataset of 44,654 items used in 2,121 procedures of 11 different categories. Read More

J Clin Exp Hepatol 2021 Jan-Feb;11(1):149-153. Epub 2020 May 22.

Department of Gastroenetrology, All India Institute of Medical Sciences, New Delhi, India.

Hemophagocytic lymphohistiocytosis is a life-threatening disorder characterized by persistent pathologic activation of cytotoxic T lymphocytes, natural killer cells, and macrophages. We present details of a young patient who presented with high-grade fever, jaundice, and breathlessness. On investigations, he had hepatitis, anemia, neutropenia, and coagulopathy. Read More

J Clin Exp Hepatol 2021 Jan-Feb;11(1):82-96. Epub 2020 Aug 9.

Department of Gastroenterology & Hepatology, Kalinga Institute of Medical Sciences, Bhubneshwar, India.

Sickle hepatopathy is an umbrella term describing various pattern of liver injury seen in patients with sickle cell disease. The disease is not uncommon in India; in terms of prevalence, India is second only to Sub-Saharan Africa where sickle cell disease is most prevalent. Hepatic involvement in sickle cell disease is not uncommon. Read More

Rinsho Ketsueki 2021 ;62(1):20-24

Division of Hematology, Department of Internal Medicine, National Defense Medical College.

Patients with refractory ascites that develops >3 months after allogenic stem cell transplantation typically have a poor prognosis. We present the case of a 61-year-old man who developed refractory massive ascites approximately 3 months after cord blood transplantation (CBT) and showed complete and spontaneous remission from ascites after 18 months. The patient complained of severe bloating and needed weekly paracentesis to manage the fluid levels. Read More

Indian J Pediatr 2021 Feb 2. Epub 2021 Feb 2.

Department of Radiology, All India Institute of Medical Sciences (AIIMS), New Delhi, India.

Transjugular liver biopsy (TJLB) is widely used in adults when percutaneous liver biopsy (PLB) is contraindicated. The authors evaluated the safety, efficacy and utility of TJLB in pediatric patients with contraindications to PLB. Twenty-three children and adolescents (13 male) underwent 24 (one patient had two separate biopsies) consecutive biopsies (TJLB) under general anaesthesia (18) or intravenous sedation (6). Read More

Diagnostics (Basel) 2021 Jan 16;11(1). Epub 2021 Jan 16.

Department of Gastroenterology, School of Medicine, Dokkyo Medical University, 880 Kitakobayashi Mibu, Tochigi 321-0293, Japan.

Background And Study Aim: Transjugular liver biopsy (TJLB) can be used in patients who are ineligible for percutaneous liver biopsy (PLB) with acute and chronic hepatic disease. This study aimed to evaluate the usefulness and safety of TJLB in patients who were not indicated for PLB.

Methods: Between July 2014 and February 2019, a total of 134 patients underwent liver biopsies at our institution. Read More

AJR Am J Roentgenol 2021 03 13;216(3):698-703. Epub 2021 Jan 13.

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Ave #1277, Wuhan, 430022, China.

Splenomegaly and thrombocytopenia are common complications in patients with cirrhosis. The present study aimed to evaluate changes in splenic volumes and platelet counts after TIPS insertion. A total of 104 patients who had a diagnosis of portal hypertension and had undergone TIPS placement between November 2015 and August 2019 were enrolled in this retrospective cohort study. Read More

Dig Dis Sci 2021 Jan 12. Epub 2021 Jan 12.

Program Director- Advanced Endoscopy Fellowship, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

The etiology of most cases of liver diseases in pregnancy can be diagnosed with a thorough history, physical examination, laboratory values, serology, and noninvasive imaging. However, atypical clinical and laboratory presentations of liver diseases/chemistries require a liver biopsy to render an accurate diagnosis in cases where the biopsy results affect the timing of delivery or impact choice of medical therapy. According to the American College of Gastroenterology, liver biopsy can be effectively and safely conducted in pregnant women. Read More

Cardiovasc Intervent Radiol 2021 Apr 4;44(4):574-579. Epub 2021 Jan 4.

Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.

Purpose: To compare the safety and efficacy of transjugular liver biopsy (TJLB) using a Quick-Core biopsy needle or a forceps biopsy in patients with liver transplantation (LT) who were suspected of having rejection.

Materials And Methods: From June 2015 to January 2017, 98 TJLBs (60 patients) with the Quick-Core biopsy needle and 95 TJLBs (58 patients) with a forceps biopsy system were attempted in patients with LT suspected of having rejection. Technical success, adequacy for diagnosis, number of biopsy instrument passes, the maximum and mean length of the obtained samples, and the complications were retrospectively analyzed. Read More

Int J Cardiol 2021 04 2;328:83-88. Epub 2020 Dec 2.

San Diego School of Medicine, Department of Pediatrics, Division of Pediatric Cardiology, University of California, USA.

Background: Fontan associated liver disease (FALD) is attributed to the limitations of the Fontan circulation, resulting in congestive hepatopathy. The technique and outcomes of transjugular liver biopsies (TJLB) in Fontan patients warrant definition as part of a rigorous FALD surveillance program.

Method: Four year review of patients with Fontan physiology who underwent a TJLB during surveillance catheterizations. Read More

Endosc Int Open 2020 Dec 17;8(12):E1850-E1854. Epub 2020 Nov 17.

Division of Gastroenterology & Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, United States.

 Endoscopic ultrasound-guided liver biopsy (EUS-LB) is an accepted technique for tissue acquisition. Traditionally, random LB has been performed with percutaneous (PC-LB) and transjugular (TJ-LB) approaches. The purpose of this study was to compare the safety profile and efficacy of EUS-LB, PC-LB, and TJ-LB. Read More

Zhonghua Gan Zang Bing Za Zhi 2020 Nov;28(11):949-953

Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.

To evaluate the effectiveness and safety of transjugular liver biopsy (TJLB) in clinical applications. Clinical data of patients who underwent TJLB in the Beijing Friendship Hospital Affiliated to Capital Medical University from November 2017 to March 2019 were retrospectively reviewed. Clinical characteristics, indications and biopsy complications and the samples quality were analyzed. Read More

Sci Rep 2020 11 26;10(1):20682. Epub 2020 Nov 26.

Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.

Transjugular intrahepatic portosystemic shunt (TIPS) can treat portal hypertensive complications and modifies hepatic hemodynamics. Modification of liver perfusion can alter contrast enhancement dynamics of liver nodules. This study investigated the diagnostic performance of contrast-enhanced ultrasound (CEUS) to diagnose hepatocellular carcinoma (HCC) in cirrhosis with TIPS. Read More

Eur J Radiol 2020 Dec 4;133:109399. Epub 2020 Nov 4.

Division of Vascular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; State University of New York, Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY, 11203, USA; Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA. Electronic address:

Purpose: This study sought to identify the complication, mortality, and readmission rates of patients undergoing either percutaneous (PCLB) or transjugular liver biopsy (TJLB) when propensity matched for demographics and hepatic comorbidities.

Methods: A retrospective review of New York's Statewide Planning and Research Cooperative System ICD9 coded database from the years 2009-2013 was conducted. Patients over the age of 18 undergoing either PCLB or TJLB were included. Read More

Radiology 2021 01 17;298(1):104-111. Epub 2020 Nov 17.

From the Department of Radiology (I.G., J.R.E., P.M., M.S., C.E.W., C. M. Shaw, A.T., C.M., F.F.) and Department of Medicine, Division of Gastroenterology and Hepatology (J.M.F.), Thomas Jefferson University, 132 S 10th St, Philadelphia, PA 19107; School of Biomedical Engineering, Sciences and Health Systems, Drexel University, Philadelphia, Pa (I.G.); Department of Surgery, Lankenau Medical Center, Wynnewood, Pa (S.G.); Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (S.S., M.C.S., C. M. Sehgal); and GE Global Research, Niskayuna, NY (K.W.).

Background The current standard for assessing the severity of portal hypertension is the invasive acquisition of hepatic venous pressure gradient (HVPG). A noninvasive US-based technique called subharmonic-aided pressure estimation (SHAPE) could reduce risk and enable routine acquisition of these pressure estimates. Purpose To compare quantitative SHAPE to HVPG measurements to diagnose portal hypertension in participants undergoing a transjugular liver biopsy. Read More

Acta Radiol 2020 Nov 9:284185120969953. Epub 2020 Nov 9.

Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA.

Background: Liver transplant hepatic venous anastomoses are usually created using "bicaval" or "piggyback" techniques, which may result in unfavorable angulation between the inferior vena cava and hepatic veins, and makes hepatic vein catheterization and tissue sampling during transjugular liver biopsy (TLB) technically challenging.

Purpose: To compare the technical successes and complications of TLBs for recipients of liver transplants with bicaval and piggyback hepatic vein anastomoses.

Material And Methods: Information on type of hepatic vein surgical anastomosis was available for 190 adult patients in whom 306 consecutive TLBs were performed during 2009-2017: 158 with bicaval and 148 with piggyback anastomoses. Read More

Life Sci 2021 Jan 2;264:118710. Epub 2020 Nov 2.

Department of Radiology, Shengjing Hospital, China Medical University, Shenyang 110004, China. Electronic address:

Aims: Hepatic venous pressure gradient (HVPG) is critical for staging and prognosis prediction of portal hypertension (PH). However, HVPG measurement has limitations (e.g. Read More

Dig Liver Dis 2020 12 2;52(12):1381-1382. Epub 2020 Nov 2.

Fondazione IRCCS Ca' Granda Ospedale maggiore Policlinico and C.R.C. "A.M. & A. Migliavacca Center for Liver Disease", Division of Gastroenterology and Hepatology, Milan, Italy.

Radiography (Lond) 2021 05 24;27(2):751-753. Epub 2020 Oct 24.

Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy. Electronic address:

J Clin Transl Hepatol 2020 Sep 8;8(3):231-239. Epub 2020 Jul 8.

Division of Gastroenterology-Hepatology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA, USA.

Hepatocellular iron accumulation in patients with chronic liver disease has been linked to adverse outcomes. The objective of this study was to identify clinical factors associated with hemosiderosis. A total of 103 consecutive liver transplant recipients were identified, in whom liver biopsy had been performed prior to transplantation. Read More