Expo clinicas neoplasias
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Transcript of Expo clinicas neoplasias
NeoplasmsPortal Hypertension
Francisco Javier Robles Saucedo
Clinical Surgery DepartmentDr. Benjamin Robles MadrigalDr. Hector Manuel Vírgen Ayala
Neoplasms
BeningMalignantMetastaticCyst
Liver Cell Adenomawomen (11:1)20-40 years oldOCPs70% lonely
SoftYellow2-15cmGlycogen & Fat (intracellular)
Liver Cell Adenoma
Abdominal pain(hemorrhage or
compresion)
Dx.MRICTBiopsy
TxResectionResection + Embolization
(Hemorrhage)
Focal Nodular Hyperplasia
Women 40 years old80% lonely5 – 10 cmCentral Star-Shaped Scar
Focal Nodular Hyperplasia
Abdominal pain (rarely)
Dx.CTMRI
TxResection
Hemangioma
Most commonWomen 3:1 (45 years old)Cavernous.< 5cm Asyntomatic
DxCT + ContrastMRI
TxResectionRadiotherapyEmbolization
Hepatocellular Carcinoma
1-3:100,000Men (2-8:1) 50-60 years old
Risk Factors:CirrhosisSmokingAlcoholContraceptivesVHB & VHC
Hepatocellular Carcinoma
SymtompsAbdominal painweight lossAnorexyNauseaBudd-Chiari SyndromeJaundiceHemobilia
Hepatocellular Carcinoma
Dx.CTMRIECOAngyographyAFPBx
Hepatocellular Carcinoma
Tx.Qx
HepatectomyAblative
Ethanol InyectionThermal Ablation
TransarterialEmbolization
CombinatedExternal RadiationSistemic
ChemotherapyInmunotherapy
Portal Hypertension
Portal Vein Pressure > 10 mm Hg
Flow Resistance Pre - Hepatic (Obstruction)Hepatic (Cirrhosis, Hepatitis)Post – Hepatic (Sx. Budd – Chiari)
Portal Circulation (>1350 ml/min)Porto-arterial FistulaSplenic circulation increment
(Sx. Banti)
Portal Hypertension
Tx.
ShuntsBallon TamponandeTIPS (Transjugular intrahepatic portosystemic shunt)VasopressinLiver TransplantEndoscopic Schlerotherapy.