Liver Flashcards
What is the venous drainage for the liver?
Hepatic- right middle and left
Caudate lobe drains directly to IVC
What is the blood supply to the liver?
Portal vein 75%
Hepatic artery
What is the path of biliary drainage?
Bile canaliculi -> segmental bile ducts->Right and left hepatic ducts-> common hepatic duct-> common bile duct at point of insertion of the cystic duct
What are the benign liver lesions?
Cavernous hemangioma
liver cysts
hepatic adenoma
focal nodular hyperplasia
When should a benign liver lesion be resected?
Symptomatic
Hemorrhage
Risk of malignant transformation
Inability to exclude malignancy
What is a cavernous hemangioma?
Benign vascular lesion
What is the most common benign hepatic tumor?
Cavernous hemangioma
Describe a cavernous hemangioma
Benign vasc lesion
women>men
30-50y/o
usually small
What are the sx of cavernous hemangioma?
Asymptomatic usually
RUQ pain or fullness
Hepatomegaly or arterial bruit in RUQ (rare)
Labs normal
What are very rare presentations of cavernous hemangiomas?
CHF Jaundice Rupture and hemorrhage Early satiety, N/V Thrombocytopenia
What imaging us used to diagnose cavernous hemangioma?
Dynamic contrast-enhanced CT
What will US show for cavernous hemangioma?
Well-circumscribed, uniformly hyperechoic
What is shown on CT that is pathognomonic for hemangioma?
Peripheral, discontinuous, intense nodular enhancement during the arterial-dominant phase with progressive centripetal fill-in on CT
What is the treatment of hemangioma if there is no change with f/u US at 6 and 12 months?
long-term f/u radiologic studies not necessary
What are indications for resection of hemangioma?
Severe sx
inability to obtain a firm diagnosis
rapid growth
rupture
