Hochwald S N, Blumgart L H
Department of Surgery, University of Florida College of Medicine, Gainesville, USA.
HPB Surg. 2000 Aug;11(6):413-9. doi: 10.1155/2000/25954.
We present a case of giant cavernous hemangioma of the liver with disseminated intravascular coagulopathy (Kasabach-Merritt syndrome) which was cured by enucleation. The 51 year old woman presented with increased abdominal girth and easy bruisability. Workup elsewhere revealed a massive hepatic hemangioma and she was started on radiation therapy to the lesion and offered an orthotopic liver transplant. After careful preoperative preparation, we felt that resection was possible and she underwent a successful enucleation. The operation and postoperative course were complicated by bleeding but she recovered and remains well in followup after 6 months. All coagulation parameters have returned to normal. Enucleation should be considered the treatment of choice for hepatic hemangiomas, including those presenting with Kasabach-Merritt syndrome. The benefits of enucleation as compared to liver transplantation for these lesions are discussed.
我们报告一例肝脏巨大海绵状血管瘤合并弥散性血管内凝血（卡萨巴赫 - 梅里特综合征），通过摘除术治愈。该51岁女性表现为腹围增加和易出现瘀斑。在其他地方的检查发现有巨大肝血管瘤，她开始接受针对该病灶的放射治疗，并被建议进行原位肝移植。经过仔细的术前准备，我们认为可以进行切除术，她接受了成功的摘除术。手术及术后过程因出血而复杂化，但她康复了，6个月后的随访情况良好。所有凝血参数已恢复正常。对于肝血管瘤，包括那些伴有卡萨巴赫 - 梅里特综合征的病例，摘除术应被视为首选治疗方法。文中讨论了摘除术与肝移植治疗这些病灶相比的益处。
