Simon Tiarah, Bakker Ilsalien S, Penninga Luit, Nellensteijn David R
Department of Surgery, St Elisabeth Hospital, Willemstad, Curaçao.
BMJ Case Rep. 2015 Feb 19;2015:bcr2014208676. doi: 10.1136/bcr-2014-208676.
Haemorrhagic rupture is a life-threatening complication of a hepatic simple cyst. A 63-year-old man presented with severe acute abdominal pain and a massive haemoperitoneum resulting from haemorrhagic rupture of a large hepatic cyst. The haemorrhagic rupture was aggravated by an overdose of vitamin K-antagonist treatment. CT scans revealed a large hepatic simple cyst. The patient was successfully treated conservatively with resuscitation, transfusion therapy and administration of coagulation agents. To date, there is no clear evidence regarding optimal treatment of haemorrhagic hepatic cyst rupture. The risk of recurrent bleeding from the haemorrhagic hepatic simple cyst, and the need for final treatment to avoid rebleeding either by percutaneous sclerotherapy, endovascular embolisation, surgical cyst resection, or surgical deroofing, is discussed.
出血性破裂是肝单纯囊肿的一种危及生命的并发症。一名63岁男性因巨大肝囊肿出血性破裂出现严重急性腹痛和大量腹腔积血。维生素K拮抗剂治疗过量加重了出血性破裂。CT扫描显示一个巨大的肝单纯囊肿。该患者通过复苏、输血治疗及给予凝血剂成功接受了保守治疗。迄今为止，关于出血性肝囊肿破裂的最佳治疗尚无明确证据。讨论了出血性肝单纯囊肿再次出血的风险，以及为避免再次出血而进行最终治疗的必要性，最终治疗方式包括经皮硬化治疗、血管内栓塞、手术囊肿切除或手术去顶术。
