title: Surgical approach to multifocal hepatocellular carcinoma with portal vein thrombosis and arterioportal shunt leading to portal hypertension and bleeding: a case report.
abstract: It is reported the case of a 69 years man who presented to the Emergency Room because of pain and abdominal distension from ascites. After admission and paracentesis placement, he developed a digestive hemorrhage due to oesophageal varices from portal ipertension secondary to the formation of a portal shunt concomitant with a multifocal HepatoCellular Carcinoma (HCC) with portal vein thrombosis (PVT). The patient underwent endoscopic varices ligation, twice transarterial embolization (TAE) of arterial branches feeding the shunt and subsequent left hepatectomy. During the postoperative course he developed mild and transient signs of liver failure and was discharged in postoperative day 16. He is alive and disease free 8 months after surgery.
authors.affiliation: Department of Surgery, Vita-Salute S Raffaele University, Milan, Italy. ratti.francesca@hsr.it
authors.forename: Francesca
authors.initials: F
authors.lastname: Ratti
authors.forename: Federica
authors.initials: F
authors.lastname: Cipriani
authors.forename: Michele
authors.initials: M
authors.lastname: Paganelli
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Ferla
authors.forename: Luca A M
authors.initials: LA
authors.lastname: Aldrighetti
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000473:pathology / Q000601:surgery*; D004621:Embolization, Therapeutic; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology / Q000601:surgery*; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects*; D011379:Prognosis; D020246:Venous Thrombosis / Q000150:complications / Q000473:pathology / Q000601:surgery*