Diagnosis and treatment of hepatic Hemangioma _46960

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Diagnosis and treatment of hepatic Hemangioma _46960 Powered By Docstoc
					?Tumor, checking, cases, liver cancer, dyspepsia

?Diagnosis and treatment of
hepatic Hemangioma


                Zhengzhou Central Hospital Li Xue-min

Hepatic Hemangioma is a benign tumor of the liver. In the cavernous
Hemangioma of the most common. Cavernous hemangiomas usually solitary,
occurred in the right lobe of liver; approximately 10 percent more
hair, can be distributed in a leaf or double-sided. Hemangioma
hepatic manifestations as anhong, blue-violet cystic uplift. Leaf or
nodular, soft, compressible, most clearly with the adjacent tissue
boundaries. Patients generally have no complaints. Hemangioma
unspecified reasons, it was considered to be intrahepatic vascular
structure Dysplasia, there are also people who believe and estrogen
levels. The number of middle-aged women, female incidence rate is 6
times higher than for men. Because the disease is no obvious symptoms,
only manifested as liver lesion, the clinic should pay attention to
distinguish hepatocellular carcinoma phase. Zhengzhou Central
Hospital Hepatobiliary and pancreatic surgery Li Xue-min

Classification of diseases

(1) cavernous hemangiomas: its slice is honeycomb, filled with blood,
microscopic examination shows size cystic sinusoidal, RBC, therein is
a thrombosis, sinusoidal between fibrous tissue SEPTA, fabric in a
small vessels and small bile ducts, see compressed of liver cells.
Fabric and sinus thrombosis in the vein of calcification, or visible.

(2), Sclerosing hemangiomas and vascular cavity closed, more fiber
interval organization is degenerative changes.
(3) vascular endothelial cells, vascular endothelial cell
proliferation in active, prone to cause malignant transformation.

(4) hepatic Hemangioma, vascular cavity narrow, fiber interval

Clinical manifestations

1. small hemangiomas multiple asymptomatic and have larger Hemangioma
hepatic area swelling and pain.

2. small hemangiomas no signs, large Angioma, reach the upper
abdominal mass, large Porta.

3. increase due to tumor following liver large, lump and compression
symptoms early without symptoms. Diagnosis is mainly based on the B-
mode ultrasound and cT, SPECT and hepatic artery angiography
confirmed. Small hemangiomas and the treatment of asymptomatic people
don't have to, you can have dynamic observation; compression can
choose partial hepatectomy. Hemangioma is solitary, more than 4 cm in
diameter. Hepatic Hemangioma in b is found out by accident, its size
and shape and volume are not necessarily, often in the case of
congenital. If still no development, no complaints, generally not
life threatening. 4 cm above is about 40% with abdominal discomfort,
hepatomegaly, appetite is not for maternal, indigestion and other
symptoms. Hepatic Hemangioma term fibrous tissue, machine of thrombus,
can cause recurrent thrombosis induced liver tumours swelling,
retraction capsular swelling and pain.

Diagnosis on the basis of

1. liver area swelling and pain, liver or touches the masses.

2. color b-shown in hepatic Hemangioma.

3.CT check: liver has density uniform low density areas, increased
tumor periphery may appear "C" shaped reinforced belt.

4. hepatic Arteriography: lesion surrounding the "vascular imaging,
Lake" contrast agent retention time is longer.

5. the laparoscopy: observation of liver tumor shape and colour of
the surface.

6.X-check: large Porta 影, diaphragm, calcification of shadow can be
Changes in hepatic Hemangioma 7.ECT display.

Treatment principle

1.5mm tumor diameter ", does not require surgical treatment, regular
review and follow-up.

2. the tumor diameter 5-10mm, surgical treatment may be considered.

3. the tumor diameter > 10mm general surgical treatment.

4. surgical methods are: (1) hepatic Hemangioma excision or liver
resection; (2) hepatic artery ligation; (3) treatment of
Intraoperative frozen.

5. non-surgical treatment: radiotherapy (1); (2) hepatic
Arteriography and tumor embolization.

Special reminder

In recent years, according to a number of cases and found that many
patients with hepatic Hemangioma development is slow, even with no
obvious development for many years, and have not been found to be
malignant. Yet found on hepatic Hemangioma, Hemangioma so ill as not
"5cm, specialized doctor, everywhere (every 6-12 months for Doppler).
If the tumor > 5cm and accompanied by pain and swelling in the liver
area, abdominal distension, na food was not good and other symptoms
when the Hemangioma of increase before surgery.

?Tumor, checking, cases, liver cancer, dyspepsia