In general, hemangiomas in the liver are basically benign tumors or congenital vascular malformations. The occurrence of this disease is not limited by age, and it is related to the patient's endocrine system. When the changes occur, patients may experience symptoms such as indigestion, nausea, bloating and pain in the liver. Under normal circumstances, the growth of hemangioma is relatively slow, and patients should go to the hospital for examination on time. Treatment of intrahepatic hemangioma 1. Surgical treatment Currently, the treatments for hepatic hemangioma mainly include hemangioma resection, hemangioma suture ligation, hepatic artery ligation, microwave solidification, radiofrequency treatment, hepatic artery embolization, etc. Liver transplantation can also be used to treat diffuse hepatic hemangiomas or giant hemangiomas that cannot be removed, such as those with liver decompensation or combined with Kasabach-Merritt syndrome. 2. Non-surgical treatment (1) Hepatic artery embolization (TAE) TAE is used to treat hepatic hemangioma because hepatic hemangioma is mainly supplied by the hepatic artery. After embolization of the artery, a thrombus may form in the tumor. The thrombus may become organized and fibrotic, causing the tumor to form a fibroma-like structure, thereby achieving the purpose of shrinking and hardening the hemangioma. (2) Microwave solidification and radiofrequency treatment of hepatic hemangioma. Microwaves can be converted into heat energy to coagulate the surrounding tissues, causing the tumor to shrink and harden locally, thus achieving the purpose of solidifying the tumor. Symptoms of intrahepatic hemangioma 1. Abdominal mass The abdominal mass has a cystic feeling, is non-tender, and has a smooth or rough surface. Conductive vascular murmurs may occasionally be heard when auscultating the mass site. 2. Gastrointestinal symptoms include dull pain and/or discomfort in the right upper abdomen, loss of appetite, nausea, vomiting, belching, fullness after eating and other indigestion symptoms. 3. Compression symptoms Huge hemangiomas can push and compress surrounding tissues and organs. Compression of the lower esophagus may cause dysphagia; compression of the extrahepatic bile duct may cause obstructive jaundice and gallbladder effusion; compression of the portal venous system may cause splenomegaly and ascites; compression of the lungs may cause dyspnea and atelectasis; compression of the stomach and duodenum may cause gastrointestinal symptoms. 4. Rupture and bleeding of hepatic hemangioma Rupture and bleeding of hepatic hemangioma may cause severe upper abdominal pain, as well as bleeding and shock symptoms. Most of them are large hepatic hemangiomas growing below the costal arch that rupture and bleed due to external force. 5. Kasabach-Merritt syndrome: coagulation abnormalities caused by thrombocytopenia and massive consumption of coagulation factors. The pathogenesis is blood retention in giant hemangiomas, which consumes a large amount of red blood cells, platelets, coagulation factors II, V, VI and fibrinogen, causing abnormal coagulation mechanism, which can further develop into DIC. 6. Other pedunculated hemangiomas that grow freely outside the liver may undergo necrosis when twisted, causing severe abdominal pain, fever, and collapse. In some patients, huge hemangiomas are accompanied by the formation of arteriovenous fistulas, which increase the amount of blood returning to the heart and lead to heart failure. |
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