PMC3573783_01
Laboratory data after admission. We administrated Sanactase M, BCAA and zinc sulfate. Serum zinc levels subsequently increased and jaundice and ammonia levels improved.
crg-0007-0049-g01.jpg
PMC3573783_01_crg-0007-0049-g01.jpg
F1
The liver disease was classified as Child-Pugh class C (table 1; fig. 1). The patient was in good general condition and was discharged (fig. 1).
a Abdominal CT before surgery; the average for the right hepatic lobe, left hepatic lobe, hepatic portal region and abdominal region was 62.1 HU. b Abdominal CT 3 months after surgery; the average CT attenuation value was 1.0 HU, which was lower than before surgery. c Abdominal CT 5 months after surgery; the average CT attenuation value was 32 HU, which was higher than 3 months after surgery.
crg-0007-0049-g02.jpg
PMC3573783_01_crg-0007-0049-g02.jpg
F2
The average of the preoperative CT values for the right hepatic lobe, left hepatic lobe, hepatic portal region and abdominal region was 62.1 Hounsfield units (HU) (fig. 2a). Absorption, as indicated by the mean CT score, was substantially lower postoperatively (fig. 2b). The mean CT value improved to 32 HU (fig. 2c).
Pathological examination of liver biopsy (HE stain, x100). The liver parenchyma shows a necrotic lesion accompanied by fibrosis and large droplets of fat (black arrowheads). The portal area was expanded due to infiltration of lymphocytes and fibrous tissue (blue arrowheads). No changes were seen in the bile ducts. Hepatocellular ballooning was evident (orange arrowheads). There was also mild to moderate fibrosis of the hepatic sinusoids (green arrowheads).
crg-0007-0049-g03.jpg
PMC3573783_01_crg-0007-0049-g03.jpg
F3
Figure 3 shows a microscopic image of a liver section obtained following biopsy on day 35 of hospitalization.