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病例报告:经导管栓塞治疗巨大肝血管瘤

A Case Report: Giant Liver Hemangioma Treated with Transcatheter Embolization.

作者信息

Tonpe Sudhanshu, Warbhe Himandri, Banode Pankaj, Bandi Sneha, Suryadevara Manasa, Reddy Guggella Swaroop

机构信息

Department of Interventional Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Department of Respiratory Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Aug 1;16(8):e65927. doi: 10.7759/cureus.65927. eCollection 2024 Aug.

Abstract

When treating patients with a massive cavernous hemangioma of the liver that requires nonsurgical therapy, transcatheter arterial embolization has proven to be an effective technique. Significant advantages include the ability to obliterate the vascular supply of these lesions and the minimally invasive nature compared to surgery. A 65-year-old woman arrived at our hospital complaining primarily of stomach pain that had been there for six months. The patient had a hard lump in the right hypochondrium on clinical examination. Ultrasound showed a large, well-defined, heterogeneous lesion with central necrotic areas, with the rest of the liver parenchyma having normal echotexture and flow in the portal vein. The 65-year-old woman's primary complaint upon arrival at our hospital was a stomach ache that had been there for six months. The results of the liver function test were normal. Upon presumptive identification of a significant hepatic hemangioma, the patient was brought to the angio-suite for angiography and proper hepatic artery embolization. Considering the patient's age, the severity of the lesion, and its highly vascular character, endovascular embolization of the proper hepatic artery using lipidol and bleomycin was performed. The patient was discharged after two days in the hospital, administered antibiotics, and advised to follow up after 15 days. Liver function after embolization was within normal limits. The patient had no symptoms after a follow-up at three months. Therefore, endovascular embolization with lipidol and bleomycin is a safe and effective method to obliterate the vascular supply to the lesion, prevent catastrophic bleeding, and provide symptomatic relief to the patient.

摘要

在治疗需要非手术治疗的巨大肝脏海绵状血管瘤患者时,经导管动脉栓塞术已被证明是一种有效的技术。其显著优点包括能够消除这些病变的血管供应,且与手术相比具有微创性。一名65岁女性因主要诉说持续6个月的胃痛前来我院就诊。临床检查发现患者右季肋部有一个硬块。超声显示一个大的、边界清晰的、不均匀的病变,伴有中央坏死区域,肝脏其余实质回声纹理正常,门静脉血流正常。该65岁女性入院时的主要诉求是持续6个月的胃痛。肝功能检查结果正常。在初步诊断为显著的肝脏血管瘤后,患者被送往血管造影室进行血管造影和适当的肝动脉栓塞。考虑到患者的年龄、病变的严重程度及其高血管特征,使用碘油和博来霉素对肝固有动脉进行了血管内栓塞。患者住院两天后出院,给予抗生素治疗,并建议15天后随访。栓塞后肝功能在正常范围内。三个月随访时患者无任何症状。因此,使用碘油和博来霉素进行血管内栓塞是一种安全有效的方法,可消除病变的血管供应,预防灾难性出血,并为患者缓解症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd04/11365718/27d6c509e711/cureus-0016-00000065927-i01.jpg

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