Okada Haruka, Koike Yuji, Kishimoto Shotaro, Mori Kosuke, Imaki Shohei, Torii Ikuo, Komatsu Hirokazu
Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Japan.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Japan.
Intern Med. 2022 Apr 15;61(8):1157-1162. doi: 10.2169/internalmedicine.8133-21. Epub 2021 Sep 25.
A 68-year-old man was transferred to our hospital because of sudden right costal pain with unmeasurable hypotension. Ultrasonography revealed possible hemorrhagic shock due to ruptured hepatocellular carcinoma (HCC). As the patient was not hemodynamically stable after primary treatment, resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed, and hemodynamic stability was then achieved. Contrast-enhanced computed tomography confirmed the diagnosis. Transcatheter artery embolization with gelatin sponge particles and coils eliminated the extravasation. The patient was discharged on day 36 post-procedure. Our observations suggest that REBOA may help achieve hemodynamic stability in cases of ruptured HCC.
一名68岁男性因突发右侧肋部疼痛伴无法测量的低血压被转至我院。超声检查显示可能因肝细胞癌（HCC）破裂导致出血性休克。由于患者在初次治疗后血流动力学不稳定，遂进行了复苏性血管内主动脉球囊阻断术（REBOA），随后实现了血流动力学稳定。增强计算机断层扫描证实了诊断。用明胶海绵颗粒和弹簧圈进行经导管动脉栓塞消除了渗漏。患者在术后第36天出院。我们的观察结果表明，REBOA可能有助于在HCC破裂病例中实现血流动力学稳定。
