Liver Lesions

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Liver Lesions
2011-01-08 22:00:58
Liver Surgery ABSITE

Liver lesion questions
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  1. Most common benign liver lesion?
  2. Liver lesion with hypervascularity on CT, no sulfur colloid scan uptake, and no Kupfer cells
    Hepatic Adenoma
  3. FNH on CT looks like this:
    CENTRAL STELLATE SCAR, may look like cancer: fibromalleolar cancer
  4. What consumptive coagulopathy can occur as a result of a hepatic angioma?
    Kasbach Merritt
  5. What do hepatic angiomas look like on CT scan?
    Hypervascular lesions with peripheral to central enhancement on CT
  6. Management of an asymptomatic hepatic adenoma?
    Stop OCP's, if regression: nada. If not: resect

    If NOT on steroids/OCP: resect
  7. Management of Schistosomiasis lesion of the liver?
    Praziquantel and control of any resultant variceal bleeding
  8. Management of pyogenic liver abscess?
    CT guided percutaneous drainage and antibiotics, surgical drainage if unstable or septic or multiple abscesses
  9. Management of an Echinococcal liver cyst?
    Tx with albendazole, do NOT resect: can spill into the abdomen and cause anaphylaxis
  10. Positive Casoni skin test =
    Echinococcal cyst
  11. Management of an amebic abscess:
    Usually just flagyl, typically dont need to drain
  12. Management of a lesion with:
    -Central stellate scar
    -Positive sulfur colloid uptake on liver scan
    FNH: just need to manage conservatively
  13. What is the #1 cause of HCC worldwide?
    Hep B virus
  14. How can you distinguish metastatic vs primary liver tumors on CT
    • Primary = hypervascular
    • Metastatic = hypovascular
  15. What is the only liver lesion that has positive sulfur colloid uptake on liver scan?
    Focal Nodular Hyperplasia
  16. What are the odds of rupture of a hepatic adenoma?
  17. What are Kupffer cells?
    Liver macrophages
  18. What is a replaced R hepatic?
    How common is it (%)?
    • R hepatic REPLACED by branch of SMA
    • 17%
  19. What is a accessory L hepatic?
    How common is it?
    • L hepatics is present, but so is a branch of the L gastric
    • 10%
  20. Normal GB ejection fraction?
  21. What is a common heart problem that arises in children with a hemangioma?