Sato Nobutaka, Hayashi Naoko, Imamura Yuu, Karashima Ryuichi, Hirashima Koutarou, Hiyoshi Yukiharu, Nagai Youhei, Watanabe Masayuki, Baba Hideo
Dept. of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
Gan To Kagaku Ryoho. 2008 Dec;35(13):2316-20.
In general, cancer does not progress very rapidly, however, it sometimes causes an oncologic emergency that requires immediate treatment, depending on the location and progression of the disease. Hemorrhage, obstruction, and perforation are typical abdominal oncologic emergencies. As for gastrointestinal bleeding, endoscopic hemostasis is a common treatment of choice. Transcatheter arterial embolization is the first treatment to select in case of intra-abdominal hemorrhage caused by rupture of a hepatocellular carcinoma. Patients with upper-gastrointestinal obstruction for unresectable cancer need to be treated considering their prognoses and treatment effects. Those with colorectal obstructions with cancers first need decompression. Patients with colorectal perforation should be operated immediately to prevent septic shock. Acute obstructive suppurative cholangitis needs endoscopic retrograde cholangiography for immediate diagnosis and treatment. Abdominal oncologic emergencies have decreased due to recent diagnostic and therapeutic improvements. However, it remains a crucial disease requiring appropriate diagnoses and prompt treatment based on the conditions of the patients and disease.
一般来说,癌症进展并不非常迅速,然而,它有时会引发肿瘤急症,这需要根据疾病的部位和进展情况立即进行治疗。出血、梗阻和穿孔是典型的腹部肿瘤急症。至于胃肠道出血,内镜止血是常用的治疗选择。经导管动脉栓塞术是肝细胞癌破裂引起腹腔内出血时的首选治疗方法。无法切除的癌症导致上消化道梗阻的患者,需要根据其预后和治疗效果进行治疗。患有结直肠癌梗阻的患者首先需要减压。结直肠癌穿孔的患者应立即手术以防止感染性休克。急性梗阻性化脓性胆管炎需要进行内镜逆行胆管造影以立即进行诊断和治疗。由于最近诊断和治疗方面的改进,腹部肿瘤急症有所减少。然而,它仍然是一种关键疾病,需要根据患者的病情和疾病情况进行适当的诊断和及时的治疗。