Related Experiment Videos
[Encapsulating peri-hepatitis. Apropos of 4 cases]
Insights
Encapsulating peri-hepatitis can cause post-sinusoidal block and chylous ascites. Angiography revealed abnormal intra-hepatic arteries and portal vein obstruction in these patients.
Area of Science:
- Hepatology
- Vascular Radiology
- Gastroenterology
Background:
- Encapsulating peri-hepatitis is a rare condition characterized by fibrous encapsulation of the liver.
- Its pathogenesis and associated vascular findings are not fully understood.
Purpose of the Study:
- To describe the clinical and angiographic findings in four cases of encapsulating peri-hepatitis.
- To investigate the vascular abnormalities and potential causes of ascites in this condition.
Main Methods:
- Selective arteriography of the coeliac trunk.
- Catheterisation of hepatic veins.
- Lymphography.
- Laparoscopy.
Main Results:
- Angiography showed sinuous intra-hepatic arteries in 3 cases and portal vein obstruction in 1 case.
- Hepatic vein catheterisation indicated a post-sinusoidal block.
- Chylous ascites was present in 2 cases.
- Lymphography was negative in 3 cases.
Conclusions:
- Encapsulating peri-hepatitis can be associated with significant vascular abnormalities, including post-sinusoidal obstruction.
- The findings suggest a complex interplay of vascular and lymphatic issues in the disease process.
- Micro-nodular cirrhosis may precede the development of encapsulating peri-hepatitis.
Abstract:
The authors report 4 cases of encapsulating peri-hepatitis, including an angiographic study. Selective arteriography of the coeliac trunk showed extremely sinuous intra-hepatic arteries in 3 of these cases, and obstruction of the portal vein, in one case. Catheterisation of the hepatic veins showed a pressure gradient between the obstructed hepatic vein and the free supra-hepatic pressure, showing a post-sinusoidal block. In 2 of the 4 cases, ascites was chylous. Lymphography carried out via lymphatics in the foot was negative in 3 cases where it was carried out. One case showed, on two successive laparoscopies, that micro-nodular cirrhosis was present before the development of encapsulating peri-hepatitis.