Tóth P, Takács I, Kerekes L, Sápy P
Chirurgische Universitätsklinik Debrecen, Móricz Zs. Krt 22., 4004 Debrecen, Ungarn.
Chirurg. 2002 Jan;73(1):83-5. doi: 10.1007/s104-002-8034-5.
Peliosis is an infrequent entity characterized by multiple blood-filled cavities mostly involving the liver. Peliosis hepatis usually appears as a rare autopsy finding in asymptomatic patients or in patients with chronic wasting diseases. However, peliosis hepatis may present as hepatic dysfunction or shock from hepatic rupture.
In our report we present the case of a 33-year-old woman with hepatic peliosis causing a hemoperitoneum resulting from liver rupture, which needed immediate surgical treatment. On the basis of symptoms and the laboratory parameters the acute abdomen was evaluated by abdominal ultrasound and CT scan, both revealing a hemoperitoneum and a lesion in the left liver lobe.
Embolization was performed by superselective catheterization of the left hepatic artery to stop the bleeding. After stabilization of the patient, left lobectomy of the liver was performed because of the ruptured 15-cm liver tumor. The patient recovered well and was discharged without residual complaints. Histopathologic analysis showed focal parenchymal peliosis.
The authors evaluate the effectiveness of the surgical strategy in a case of life-threatening focal hepatic disorder. Besides surgery, the authors emphasize the importance of invasive radiological interventions in these cases.
肝紫癜是一种罕见病症，其特征为多个充满血液的腔隙，主要累及肝脏。肝紫癜通常表现为无症状患者或慢性消耗性疾病患者罕见的尸检发现。然而，肝紫癜可能表现为肝功能障碍或肝破裂导致的休克。
在我们的报告中，我们介绍了一名33岁女性的病例，其肝紫癜导致肝破裂引起血腹，需要立即进行手术治疗。根据症状和实验室参数，通过腹部超声和CT扫描对急腹症进行评估，两者均显示血腹和左肝叶病变。
通过对左肝动脉进行超选择性插管栓塞以止血。患者病情稳定后，由于15厘米的肝肿瘤破裂，进行了左肝叶切除术。患者恢复良好，出院时无残留不适。组织病理学分析显示局灶性实质肝紫癜。
作者评估了在危及生命的局灶性肝脏疾病病例中手术策略的有效性。除了手术，作者强调了侵入性放射学干预在这些病例中的重要性。
