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肝内动静脉瘘合并弥漫性肝血管瘤病的栓塞治疗。1例成人病例报告及文献复习。

Embolisation of arteriovenous intrahepatic fistulas associated with diffuse haemangiomatosis of the liver. Report of a case in an adult and review of the literature.

作者信息

Pasqual Enricomaria, Bacchetti Stefano, Gasparini Daniele, Sponza Massimo, Cagol Pier Paolo

机构信息

Surgical Semeiotics Unit, Department of Surgical Science, University of Udine, Udine

出版信息

Chir Ital. 2007 Sep-Oct;59(5):701-5.

Abstract

Diffuse hepatic haemangiomatosis is rare in adults. Association with high output intrahepatic arteriovenous fistulas has been described. To avoid heart failure complications, treatment is essential. The second case in the literature, treated with repeated transcatheter arterial embolizations (TAE) but complicated by infection of multiple haemangiomas and by Kasabach-Merritt syndrome, is presented. Complications were due to the persistent presence of haemangiomas within the liver, where an impressive collection of platelets and a superinfection were observed. Therefore, to treat arteriovenous fistula-related problems and to prevent possible complications due to persistence of the haemangiomas, surgical removal should be preferred over embolisation.

摘要

弥漫性肝血管瘤病在成人中罕见。已有与高输出量肝内动静脉瘘相关的报道。为避免心力衰竭并发症,治疗至关重要。本文介绍了文献中的第二例病例,该病例接受了反复经导管动脉栓塞术(TAE)治疗,但并发了多发性血管瘤感染和卡萨巴赫-梅里特综合征。并发症是由于肝脏内持续存在血管瘤,在那里观察到大量血小板聚集和重叠感染。因此,为治疗动静脉瘘相关问题并预防因血管瘤持续存在可能导致的并发症,手术切除应优于栓塞治疗。

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