Mandarano R, Ciccone A, Natale A, Rossi de Vermandois S
USL n. 22 di Valtiberina, San Sepolcro, Arezzo.
Minerva Chir. 1993 May 15;48(9):491-4.
The paper reports four cases of spontaneous rupture of hepatocarcinoma which were brought to the authors' attention together with the resulting hemoperitoneum. Following a short review of the literature, the authors focus on the relations between hepatocarcinoma and liver cirrhosis, on the causes which lead to the rupture of hepatocarcinoma and on its diagnosis, underlining the importance of abdominal scan with ultrasonic-guided needle biopsy. The paper stresses that, where the patient's general and local conditions allow, surgery should take the form of typical or atypical hepatic resection, and affirms that ligature of the hepatic artery associated with local hemostatic measures loads to a high percentage of early peri- or postoperative mortality, as well encouraging the early recurrence of hemorrhage.
本文报道了4例原发性肝癌自发性破裂病例,这些病例因并发腹腔积血而引起作者关注。在对相关文献进行简要回顾后,作者重点探讨了肝癌与肝硬化的关系、导致肝癌破裂的原因及其诊断,强调了超声引导下经皮肝穿刺活检腹部扫描的重要性。本文强调,在患者全身及局部情况允许的情况下,手术应采用典型或非典型肝切除术,并指出肝动脉结扎联合局部止血措施会导致较高的早期围手术期或术后死亡率,同时也会促使出血早期复发。