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出血性休克的罕见病因:肝细胞癌胃壁种植破裂

A Rare Cause of Haemorrhagic Shock: Rupture of Gastric Wall Seeding of Hepatocellular Carcinoma.

作者信息

Ishimaru Naoki, Fujikawa Hirohisa, Niwa Kazuya, Kobayashi Yoshifumi

机构信息

Department of Surgery, Suwa Central Hospital, 4300 Tamagawa, Chino, Nagano 3918503, Japan.

Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 1130033, Japan.

出版信息

Case Reports Hepatol. 2022 Mar 12;2022:6560834. doi: 10.1155/2022/6560834. eCollection 2022.

Abstract

Ruptured hepatocellular carcinoma (HCC) can lead to peritoneal dissemination. However, gastric wall seeding from HCC is exceedingly rare, and little is known about its clinical course. Herein, we report a case of an 88-year-old man who presented with a four-hour history of nausea, vomiting, and upper abdominal pain. He has a history of ruptured HCC during surgery. The patient underwent an emergency laparotomy on account of haemorrhagic shock, which confirmed the diagnosis of ruptured HCC with gastric wall seeding. The findings from this study showed that the ruptured HCC can seed into the stomach wall, and the implanted lesions may rupture and lead to life-threatening haemorrhagic shock. Surgery is an effective treatment for bleeding from the implanted lesions.

摘要

破裂性肝细胞癌(HCC)可导致腹膜播散。然而,HCC胃壁种植极为罕见,对其临床病程了解甚少。在此,我们报告一例88岁男性患者,其有4小时的恶心、呕吐及上腹部疼痛病史。他曾在手术中发生过HCC破裂。患者因失血性休克接受了急诊剖腹手术,术中确诊为破裂性HCC伴胃壁种植。本研究结果表明,破裂性HCC可种植至胃壁,植入性病变可能破裂并导致危及生命的失血性休克。手术是治疗植入性病变出血的有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47a5/8934241/0dc296a57af4/CRIHEP2022-6560834.001.jpg

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