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肝滤泡性结节增生经动脉栓塞后的组织升华——病例报告

Tissue sublimation follow transarterial embolization of a follicular nodular hyperplasia of the liver-report of a case.

作者信息

Ambe Peter C, Jansen Stefan, Zirngibl Hubert

机构信息

Department of Surgery, Helios University Hospital Wuppertal, Witten - Herdecke University, Heusnerstr. 40, 42283, Wuppertal, Germany.

出版信息

BMC Gastroenterol. 2017 Aug 1;17(1):91. doi: 10.1186/s12876-017-0648-z.

Abstract

BACKGROUND

Follicular nodular hyperplasia (FNH) is a common benign liver tumor for which conservative management is indicated. Surgical or interventional management is indicated in symptomatic cases. Transarterial embolization (TAE) has been extensively used to manage unresectable liver tumors. Sublimation describes a change of physical state from solid to gas. Hepatic tissue sublimation following TAE has so far not been reported in medical literature.

CASE PRESENTATION

A 30 year - old male patient presenting with pain to the upper abdomen due to a large FNH was managed with TAE. Routine radiographic control on post-intervention day one was within normal limits. Imaging due to right upper quadrant pain with fever and elevated inflammatory markers and liver enzymes on day two after TAE revealed a marked reduction of the FNH accompanied by the presence of a large volume of gas collection without signs of abscess formation. This change of state from solid to gas without sign of abscess formation within 2 days after TAE was described as hepatic tissue sublimation. The patient was managed conservatively and discharge 12 days after TAE.

CONCLUSION

Tissue sublimation has hardly been reported in medical literature. This to the best of our knowledge is the first documented case of hepatic tissue sublimation following TAE.

摘要

背景

滤泡性结节增生(FNH)是一种常见的肝脏良性肿瘤,通常采取保守治疗。有症状的病例则需进行手术或介入治疗。经动脉栓塞术(TAE)已被广泛用于治疗无法切除的肝脏肿瘤。升华是指物质从固态直接变为气态的物理状态变化。迄今为止,医学文献中尚未报道过TAE术后肝组织升华的情况。

病例介绍

一名30岁男性患者因巨大FNH出现上腹部疼痛,接受了TAE治疗。术后第一天的常规影像学检查结果正常。TAE术后第二天,患者因右上腹疼痛、发热、炎症指标和肝酶升高进行影像学检查,结果显示FNH明显缩小,伴有大量气体积聚,但无脓肿形成迹象。TAE术后2天内,肝脏组织从固态变为气态且无脓肿形成的这种状态变化被描述为肝组织升华。该患者接受了保守治疗,并在TAE术后12天出院。

结论

医学文献中几乎没有关于组织升华的报道。据我们所知,这是首例有文献记载的TAE术后肝组织升华病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b359/5540510/336b2a457fa3/12876_2017_648_Fig1_HTML.jpg

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