Kanashima R, Nagasue N, Kobayashi M, Inokuchi K
Jpn J Surg. 1977 Dec;7(4):246-52. doi: 10.1007/BF02469357.
A case of tumor embolism in the right atrium after hepatic artery ligation for hepatoma was reported. Patient was a 55 year old male complaining of upper abdominal pain. Preoperative angiogram and scintigram revealed multinodular hepatomas in the right and middle his condition gradually deteriorated thereafter and sudden hypotension occurred on the 22nd postoperative day with a fatal sequela. At autopsy, the orifice of the right atrium was impacted by a tumor embolus. The cause of death seemed to be attributable to this embolus liberated from the hepatic veins. Accordingly, we emphasize the necessity of careful angiographic evaluation not only of the hepatic inflow but of the outflow tract in performing hepatic artery ligation as a treatment of nonresectable hepatoma.
报告了一例肝癌肝动脉结扎术后右心房肿瘤栓塞病例。患者为一名55岁男性，主诉上腹部疼痛。术前血管造影和闪烁扫描显示右叶和中叶有多发性肝癌。此后其病情逐渐恶化，术后第22天突然出现低血压，并导致致命后果。尸检时，右心房口被肿瘤栓子阻塞。死亡原因似乎是来自肝静脉的栓子。因此，我们强调在进行肝动脉结扎术治疗不可切除肝癌时，不仅要仔细进行肝血流的血管造影评估，还要对流出道进行评估。
