Department of Hepatobiliary Surgery, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, People's Republic of China.
Department of Pathology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, People's Republic of China.
BMC Gastroenterol. 2021 Feb 23;21(1):84. doi: 10.1186/s12876-021-01666-z.
Hepatic cavernous hemangioma is the most common type of benign liver tumor. Although ruptures and hemorrhages of hepatic hemangioma are rare complications, they are associated with high mortality. Most practitioners only pay more attention to abdominal hemorrhages caused by the rupture of hepatic hemangiomas. However, spontaneous intracapsular hemorrhages can often be neglected and poorly understood.
A 65-year-old man was referred to our institution with right upper quadrant pain, which had occurred suddenly and without a history of recent trauma. The blood test results were normal. Magnetic resonance imaging (MRI) of the abdomen showed a cystic mass in the right liver lobe. Considering the possibility of hepatic cystadenoma with hemorrhage, the patient underwent a right hepatic lobectomy. The pathological findings unexpectedly revealed intratumoral hemorrhage of hepatic hemangioma. The patient recovered well and was discharged eight days after surgery.
Intracapsular hemorrhage of hepatic cavernous hemangioma is challenging to diagnose and has a high potential risk of rupture. MRI is beneficial for diagnosing subacute internal hemorrhage cases, and it is recommended to undergo surgery for patients with a definitive diagnosis.
肝海绵状血管瘤是最常见的良性肝肿瘤。尽管肝血管瘤破裂和出血是罕见的并发症，但它们与高死亡率相关。大多数医生仅更关注肝血管瘤破裂引起的腹部出血。然而，自发性囊内出血常被忽视且了解甚少。
一名 65 岁男性因右上腹疼痛就诊，疼痛突然发生，无近期外伤史。血液检查结果正常。腹部磁共振成像（MRI）显示右肝叶有囊性肿块。考虑到肝囊腺瘤伴出血的可能性，患者接受了右肝叶切除术。出乎意料的病理结果显示肝海绵状血管瘤内出血。患者术后恢复良好，术后 8 天出院。
肝海绵状血管瘤囊内出血的诊断具有挑战性，且有较高的破裂风险。MRI 有助于诊断亚急性内出血病例，建议对确诊患者进行手术。
