Hsieh J S, Huang C J, Huang Y S, Sheen P C, Huang T J
AJR Am J Roentgenol. 1987 Oct;149(4):715-7. doi: 10.2214/ajr.149.4.715.
Seventeen patients with intraperitoneal hemorrhage due to spontaneous rupture of hepatocellular carcinoma were treated by emergency transcatheter arterial embolization. Fine-needle aspiration cytology was used to establish the histologic diagnosis in 11 patients with no history of hepatic malignancy. The other six patients had a pathologic confirmation of hepatic malignancy by open biopsy before admission. Pretreatment angiography showed extravasation of contrast material from the hepatic tumor in four patients (24%). In the other 13 patients, only hypervascular tumors were seen. Successful hemostasis was achieved in all patients. Fourteen patients survived after the embolization; the other three died immediately after embolization. Of the 14 patients, 11 died later (survival time ranged from 16 to 386 days). The remaining three patients are still alive at 3, 7, and 15 months, respectively, after the procedure. No serious complications related to embolization were encountered. Most patients had pain and fever. We conclude that emergency arterial embolization is an effective alternative to surgery for hepatic hemostasis in patients with spontaneous rupture of hepatocellular carcinoma.
17例因肝细胞癌自发性破裂导致腹腔内出血的患者接受了急诊经导管动脉栓塞治疗。11例无肝脏恶性肿瘤病史的患者采用细针穿刺细胞学检查来确立组织学诊断。另外6例患者在入院前经手术活检获得肝脏恶性肿瘤的病理确诊。治疗前血管造影显示4例患者（24%）的肝肿瘤有造影剂外渗。在其他13例患者中，仅见肿瘤血管丰富。所有患者均成功止血。14例患者栓塞术后存活；另外3例在栓塞术后即刻死亡。在这14例患者中，11例随后死亡（生存时间为16至386天）。其余3例患者在术后分别于3个月、7个月和15个月时仍存活。未出现与栓塞相关的严重并发症。大多数患者有疼痛和发热症状。我们得出结论，对于肝细胞癌自发性破裂的患者，急诊动脉栓塞是一种有效的替代手术的肝脏止血方法。
