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Acute paranoid psychosis as sole clinical presentation of hepatic artery thrombosis after living donor liver transplantation.

作者信息

Goralczyk Armin D, Meier Volker, Ramadori Giuliano, Obed Aiman, Lorf Thomas

机构信息

Department of General and Visceral Surgery, University Medical Center Göttingen, Göttingen, Germany.

出版信息

BMC Surg. 2010 Feb 22;10:7. doi: 10.1186/1471-2482-10-7.

DOI:10.1186/1471-2482-10-7
PMID:20175918
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2836309/
Abstract

BACKGROUND

Hepatic artery thrombosis is a devastating complication after orthotopic liver transplantation often requiring revascularization or re-transplantation. It is associated with considerably increased morbidity and mortality. Acute cognitive dysfunction such as delirium or acute psychosis may occur after major surgery and may be associated with the advent of surgical complications.

CASE PRESENTATION

Here we describe a case of hepatic artery thrombosis after living-donor liver transplantation which was not preceded by signs of liver failure but rather by an episode of acute psychosis. After re-transplantation the patient recovered without sequelae.

CONCLUSION

This case highlights the need to remain cautious when psychiatric disorders occur in patients after liver transplantation. The diagnostic procedures should not be restricted to medical or neurological causes of psychosis alone but should also focus vascular complications related to orthotopic liver transplantation.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ead1/2836309/a33be7447d1f/1471-2482-10-7-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ead1/2836309/a33be7447d1f/1471-2482-10-7-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ead1/2836309/a33be7447d1f/1471-2482-10-7-1.jpg

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本文引用的文献

1
Early hepatic artery thrombosis after liver transplantation: diagnosis and treatment.肝移植术后早期肝动脉血栓形成:诊断与治疗
Transplant Proc. 2007 May;39(4):1195-6. doi: 10.1016/j.transproceed.2007.02.017.
2
Pathogenesis of hepatic encephalopathy: the tumour necrosis factor-alpha theory.肝性脑病的发病机制:肿瘤坏死因子-α理论
Eur J Clin Invest. 2007 Apr;37(4):291-304. doi: 10.1111/j.1365-2362.2007.01778.x.
3
Central nervous system dysfunction after noncardiac surgery and anesthesia in the elderly.老年人非心脏手术及麻醉后的中枢神经系统功能障碍
Anesthesiology. 2007 Mar;106(3):622-8. doi: 10.1097/00000542-200703000-00026.
4
Risk factors contributing to hepatic artery thrombosis following living-donor liver transplantation.
J Hepatobiliary Pancreat Surg. 2006;13(2):105-9. doi: 10.1007/s00534-005-1015-y.
5
Delirium in older persons.老年人的谵妄
N Engl J Med. 2006 Mar 16;354(11):1157-65. doi: 10.1056/NEJMra052321.
6
Delirium: acute cognitive dysfunction in the critically ill.谵妄:危重症患者的急性认知功能障碍。
Curr Opin Crit Care. 2005 Aug;11(4):360-8. doi: 10.1097/01.ccx.0000170503.76528.4b.
7
The role of complex hepatic artery reconstruction in orthotopic liver transplantation.复杂肝动脉重建在原位肝移植中的作用。
Liver Transpl. 2003 Sep;9(9):970-5. doi: 10.1053/jlts.2003.50167.
8
Hepatic artery thrombosis after adult liver transplantation.成人肝移植术后肝动脉血栓形成
Liver Transpl. 2003 Jun;9(6):612-20. doi: 10.1053/jlts.2003.50098.
9
Uni- and multi-variate analysis of risk factors for early and late hepatic artery thrombosis after liver transplantation.肝移植术后早期和晚期肝动脉血栓形成危险因素的单因素和多因素分析。
Transplantation. 2001 Mar 27;71(6):767-72. doi: 10.1097/00007890-200103270-00014.
10
Hepatic artery thrombosis after orthotopic liver transplantation: a review of nonsurgical causes.
Liver Transpl. 2001 Feb;7(2):75-81. doi: 10.1053/jlts.2001.22040.