Liu Yuk Ho, Lo Eugene Yee Juen, Lee Kit Fai, Chong Charing Ching Ning, Lai Paul Bo San
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, Hong Kong.
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, Hong Kong.
Int J Surg Case Rep. 2020;70:83-86. doi: 10.1016/j.ijscr.2020.04.008. Epub 2020 May 11.
Upper gastrointestinal bleeding (UGIB) in patients suffering from hepatocellular carcinoma (HCC) is usually due to oesophageal or gastric varices secondary to portal hypertension. Very rarely, HCC can directly invade into the stomach or duodenum resulting in UGIB.
A 62-year-old man presented to the emergency department for haematemesis and tarry stool. He was a hepatitis B carrier and had received open radiofrequency ablation and wedge resection for HCC previously. Urgent endoscopy and contrast computed tomography confirmed recurrent HCC invading into the duodenum. The patient received radical resection and remained disease free for 7 years after the operation.
Direct invasion into gastrointestinal tract by HCC is rare. Different modalities of treatment have been reported in the literature with variable success. En-bloc resection should be considered if surgically feasible in order to achieve good haemostasis and possible long term survival.
Upper gastrointestinal bleeding is a rare presentation of hepatocellular carcinoma and long term survival can be achieved by curative surgery.
肝细胞癌（HCC）患者的上消化道出血（UGIB）通常是由于门静脉高压继发的食管或胃静脉曲张所致。HCC直接侵犯胃或十二指肠导致UGIB的情况非常罕见。
一名62岁男性因呕血和柏油样便就诊于急诊科。他是乙肝携带者，此前曾接受过HCC的开放性射频消融和楔形切除术。紧急内镜检查和增强计算机断层扫描证实复发性HCC侵犯十二指肠。患者接受了根治性切除术，术后7年无疾病复发。
HCC直接侵犯胃肠道的情况罕见。文献报道了不同的治疗方式，效果各异。如果手术可行，应考虑整块切除，以实现良好的止血和可能的长期生存。
上消化道出血是肝细胞癌的一种罕见表现，根治性手术可实现长期生存。
