What causes pain in the liver area caused by hepatic hemangioma?

Pain in the liver area is a common symptom of hepatic hemangioma. Patients may also experience abdominal masses and gastrointestinal symptoms, such as loss of appetite, nausea, vomiting, belching, etc., so attention should be paid to these symptoms.

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

Indigestion symptoms such as dull pain and/or discomfort in the right upper abdomen, loss of appetite, nausea, vomiting, belching, and fullness after eating.

3. Compression symptoms

Giant 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 symptoms of bleeding and shock. 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 consumption of large amounts 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. Others

When a pedunculated hemangioma growing free outside the liver twists, necrosis may occur, 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.