V. Di Martino

Thrombose portale par diffusion de cyanoacrylate au décours de l'obturation de varices gastriques hémorragiques.

[2] Abu-Abeid S, Bar Zohar D, Sagie B, Klausner J. Treatment of intra-gastric band migration following laparoscopic banding: safety and feasibility of simultaneous laparoscopic band removal and replacement. Obes Surg 2005;15:849—52. [3] Nocca D, Frering V, Gallix B, de Seguin des Hons C, Noël P, Foulonge MA, et al. Migration of adjustable gastric banding from a cohort study of 4236 patients. Surg Endosc 2005;19:947—50. [4] Silecchia G, Restuccia A, Elmore U, Polito D, Perrotta N, Genco A, et al. Laparoscopic adjustable silicone gastric banding: prospective evaluation of intragastric migration of the lap-band. Surg Laparosc Endosc Percutan Tech 2001;11:229—34. [5] De Roover A, Detry O, Coimbra C, Hamoir E, Honoré P, Meurisse M. Pylephlebitis of the portal vein complicating intragastric migration of an adjustable gastric band. Obes Surg 2006;16:369—71. [6] Calmes JM, Bettschart V, Raffoul W, Suter M. Band infection with splenoportal venous thrombosis: an unusual but severe complication of gastric banding. Obes Surg 2002;12:699—702.

L’hepar lobatum carcinomatosum : une cause rare d’hypertension portale compliquant les métastases hépatiques d’un carcinome mammaire

SUMMARY Hepar lobatum carcinomatosum is an acquired liver dysmorphy associated with liver metastases of carcinoma, usually breast carcinoma. It may cause portal hypertension. The pathogenesis of this condition appears to be related to multifocal occlusion of intrahepatic branches of the portal vein by neoplasic thrombi and desmoplastic changes. The prognosis is poor despite apparent tumor regression on imaging. We report a case of variceal bleeding revealing a hepar lobatum carcinomatosum. Magnetic resonance imaging supported this diagnosis which was suspected in the clinical context.

Severe acute pancreatitis related to the use of adefovir in a liver transplant recipient.

Adefovir dipivoxil is a nucleotide analogue of adenosine monophosphate, which provides strong inhibition of the hepatitis B virus (HBV) polymerase. The most common side effects are renal toxicity and hypophosphoremia [1]. In a recent multicenter trial of adefovir dipivoxil in HBV-infected patients undergoing liver transplantation and HBV-infected liver transplant recipients, adefovir dipivoxil was reported to have a good safety profile [2], and unlike with nucleoside analogues, no mitochondrial toxicity or pancreatitis was reported with this drug. We report the first case of acute pancreatitis related to the use of adefovir dipivoxil in a HBV-infected liver transplant recipient. The withdrawal of adefovir dipivoxil resulted in HBV reactivation causing fatal liver failure.

A case of isolated splenic infarction associated with a foramen ovale and an interatrial septal aneurysm

Splenic infarction is a rare cause of abdominal pain. We describe an unusual case of splenic infarction in a patient with both a foramen ovale and an interatrial septal aneurysm. Although we did reach a consensus about the appropriate medical strategy, the patient underwent a percutaneous closure of the foramen ovale with insertion of a self-expandable septal occluder device. Antiplatelet agents were administered after surgery and there were no complications at the six-month follow-up.