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门静脉栓塞术后肝腺瘤破裂

Hepatic adenoma rupture following portal vein embolization.

作者信息

Kis Lilla E, Centeno Barbara A, Anaya Daniel A, Kis Bela

机构信息

Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA.

Morsani College of Medicine, University of South Florida, Tampa, FL.

出版信息

Radiol Case Rep. 2020 Apr 5;15(6):664-667. doi: 10.1016/j.radcr.2020.03.002. eCollection 2020 Jun.

Abstract

Hepatic adenomas are benign liver tumors typically found in females of reproductive age. Though benign, hepatic adenomas are highly vascularized tumors, thus rupture and consequent hemorrhage present a feared complication. We report a case of a 31-year-old woman with hepatic adenoma who underwent preoperative portal vein embolization and subsequently suffered a rupture of her tumor. We postulate that the change in blood flow after portal vein embolization, a phenomenon known as the hepatic artery buffer response, may have contributed to the tumor rupture, though the possibility that the rupture was purely incidental remains. There is currently no prior report of such rupture occurring following portal vein embolization, and this case brings to light a potentially fatal complication of a generally safely regarded procedure in patients with hepatic adenoma.

摘要

肝腺瘤是一种良性肝脏肿瘤,通常见于育龄期女性。尽管是良性肿瘤,但肝腺瘤是血管高度丰富的肿瘤,因此破裂及随之而来的出血是令人担忧的并发症。我们报告一例31岁患有肝腺瘤的女性患者,该患者接受了术前门静脉栓塞,随后肿瘤发生破裂。我们推测门静脉栓塞后血流的变化,即所谓的肝动脉缓冲反应,可能促成了肿瘤破裂,不过破裂纯粹是偶然发生的可能性仍然存在。目前尚无门静脉栓塞后发生这种破裂的既往报道,该病例揭示了肝腺瘤患者中一种通常被认为安全的手术可能存在的潜在致命并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de31/7136602/908328f26132/gr1.jpg

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