GEORGE FELIPE BEZERRA DARCE

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/02 - Laboratório de Anatomia Médico-Cirúrgica, Hospital das Clínicas, Faculdade de Medicina

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  • article 0 Citação(ões) na Scopus
    HEPATOSPLENIC SCHISTOSOMIASIS-ASSOCIATED CHRONIC PORTAL VEIN THROMBOSIS: RISK FACTOR FOR HEPATOCELLULAR CARCINOMA?
    (2023) DARCE, George Felipe Bezerra; MAKDISSI, Fabio Ferrari; ANDO, Sabrina de Mello; FONSECA, Gilton Marques; KRUGER, Jaime Arthur Pirola; COELHO, Fabricio Ferreira; ROCHA, Manoel de Souza; HERMAN, Paulo
    BACKGROUND: Hepatosplenic schistosomiasis is an endemic disease prevalent in tropical countries and is associated with a high incidence of portal vein thrombosis. Inflammatory changes caused by both parasitic infection and portal thrombosis can lead to the development of chronic liver disease with potential carcinogenesis. AIMS: To assess the incidence of portal vein thrombosis and hepatocellular carcinoma in patients with schistosomiasis during long-term follow-up. METHODS: A retrospective study was conducted involving patients with schistosomiasis followed up at our institution between 1990 and 2021. RESULTS: A total of 126 patients with schistosomiasis were evaluated in the study. The mean follow-up time was 16 years (range 5-31). Of the total, 73 (57.9%) patients presented portal vein thrombosis during follow-up. Six (8.1%) of them were diagnosed with hepatocellular carcinoma, all with portal vein thrombosis diagnosed more than ten years before. CONCLUSIONS: The incidence of hepatocellular carcinoma in patients with schistosomiasis and chronic portal vein thrombosis highlights the importance of a systematic long-term follow-up in this group of patients.
  • article 3 Citação(ões) na Scopus
    Liver Surgery: Important Considerations for Pre- and Postoperative Imaging
    (2022) FARIA, Luisa Leitao de; DARCE, George Felipe; BORDINI, Andre Leopoldino; HERMAN, Paulo; JEISMANN, Vagner Birk; OLIVEIRA, Irai Santana de; ORTEGA, Cinthia D.; ROCHA, Manoel de Souza
    Liver surgery may be a curative treatment option not only for primary liver neoplasms but also for liver metastases in selected patients. The number of liver surgeries performed worldwide has increased, but surgical morbidity associated with these surgeries remains significant. Therefore, radiologists need to understand the terminology, surgical techniques, resectability and unresectability criteria, and possible postoperative complications as these are part of the decision-making process. Because vascular and biliary variations are common, an adequate preoperative anatomic evaluation determines the best surgical technique, helps identify patients in whom additional surgical steps will be required, and reduces the risk of inadvertent injury. The surgeon must ensure that the future liver remnant is sufficient to maintain adequate function, aided by the radiologist who can provide valuable information such as the presence of steatosis, biliary dilatation, signs of cirrhosis, and portal hypertension, in addition to the volume of the future liver remnant. Postoperative complications must also be understood and evaluated. The most common postoperative complications are vascular (bleeding, thrombosis, and ischemia), biliary (fistulas, bilomas, and strictures), infectious (incisional or deep), those related to liver failure, and even tumor recurrence. An invited commentary byWinslow is available online. (C) RSNA, 2022
  • article 2 Citação(ões) na Scopus
    Post-esophagectomy Symptomatic Dunbar Syndrome: A rare diagnosis of abdominal pain after surgery
    (2020) TAKEDA, Flavio Roberto; DARCE, George Felipe Bezerra; SOBRADO, Lucas Faraco; FARIA, Luisa Leitao de; TUSTUMI, Francisco; SALLUM, Rubens Antonio Aissar; ROCHA, Manoel de Souza; RIBEIRO JUNIOR, Ulysses; CECCONELLO, Ivan
    INTRODUCTION: Dunbar syndrome is a rare anatomical abnormality characterized by the extrinsic compression of the celiac trunk by the median arcuate ligament (MAL). Though it is rarely misdiagnosed, the clinical diagnosis may be difficult, especially after complex visceral surgery such as esophagectomy. PRESENTATION OF CASE: A 62-year-old male patient with a squamous cell carcinoma of the distal esophagus, placed under trimodal treatment (chemotherapy, radiotherapy followed by hybrid minimal invasive 2-field esophagectomy) presented with abdominal pain refractory to analgesics, anti-spasmodic, opioids, and neuronal celiac plexus ablation in the late post-operative period. He was diagnosed with extrinsic celiac trunk compression based on abdominal angiotomography findings. Retrospectively, similar images were found in conventional abdominal tomography at pre-operative staging, but this time, the patient had only dysphagia. After surgical treatment of MAL, the patient had total relief of pain and symptoms. DISCUSSION: Abdominal pain after complex surgical procedures is very frequent and its investigation is mandatory, even more after refractory clinical management. Dunbar syndrome is related to ambiguous abdominal pain. It is uncommon and its diagnosis with angiotomography is accessible. CONCLUSION: Vascular disorders should be investigated in cases of abdominal pain after complex surgical procedures. (C) 2020 The Authors.
  • conferenceObject
    HEPATIC ANGIOMYOLIPOMAS: CLINICAL AND IMAGING FINDINGS
    (2023) SILVEIRA, Sergio; TUSTUMI, Francisco; DARCE, George F.; JEISMANN, Vagner B.; FONSECA, Gilton M.; KRUGER, Jaime Arthur Pirola; MAKDISSI, Fabio Ferrari; OLIVEIRA, Irai Santana de; ROCHA, Manoel de Souza; COELHO, Fabricio F.; HERMAN, Paulo