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Resumen Los hemangiomas son las proliferaciones más frecuentes en la edad pediátrica, y el hemangioma hepático es de los más comunes entre los viscerales. El diagnóstico precoz es importante para orientar el tratamiento. Se presenta el caso de un neonato con compromiso ventilatorio secundario al efecto de una masa gigante, que ecográficamente correspondió a un hemangioma hepático. Se realizó resección quirúrgica y, ulteriormente, fue enviada a patología, que confirmó el diagnóstico.
Abstract Hemangiomas are the most frequent proliferations in children, and liver hemangiomas are the most common among those in the viscera. Early diagnosis to focus treatment is important. We present the case of a neonate with compromised breathing secondary to the effect of a giant mass that echographically appeared to be a hepatic hemangioma. Surgical resection and subsequent pathology confirmed the diagnosis.
Subject(s)
Humans , Male , Infant, Newborn , Kasabach-Merritt Syndrome , Hemangioma , Liver , TherapeuticsABSTRACT
Objective?To establish the way and curative effect of joint operation of CO2laser and low temperature plasma radiofrequency ablation for giant hemangioma of the larynx.?Methods?We tried to using joint operation of CO2laser and low temperature plasma radiofrequency ablation for 15 patients with giant hemangioma of the larynx.?Results?We followed up all the patients from 9 months to three years. One case recurred and treated by minimally invasive operation one more time, without recurrence after two years. The patients with mild pain and their laryngeal function were better protected. All the cases without incision of tracheal and no severe complications such as dyspnea and hemorrhage occurred.?Conclusion?The joint operation treatment of CO2laser and low temperature plasma radiofrequency ablation for giant hemangioma of the larynx holds advantages of micro-traumatic, safe and effective, and worthy to be extended on clinical.
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Objective To evaluate the risk factors of massive blood loss in resection of giant liver hemangioma.Method The clinical data of 141 patients who underwent giant liver hemangioma resection were retrospectively studied.These data included general physical condition,laboratory tests,radiologic findings,and various surgical parameters.The patients were divided into the massive blood loss group (＞ 1 000 ml,n =27) and the minor blood loss group (≤1 000 ml,n =114).Logistic regression was performed to determine the risk factors of intraoperative massive blood loss.Results The average diameter of the liver hemangioma was significantly greater in the massive blood loss group than that in the minor blood loss group [(21.7 ± 8.5) cm vs.(14.1 ± 5.3) cm,P ＜ 0.05].The incidences of preoperative leukopenia,anemia,thrombocytopenia and prolonged prothrombin time were higher in the massive blood loss group than that in the minor blood loss group (48.1％ vs.16.7％,37.0％ vs.11.4％,25.9％ vs.3.5％,22.2％ vs.3.5％,respectively,all P ＜ 0.05).Hepatic hemangioma with compressed hepatic veins,inferior vena cava and porta hepatis were more frequently found in the massive blood loss group than in the minor blood group (55.6％ vs.14.9％,44.4％ vs.14.0％,55.6％ vs.12.3％,respectively,all P＜0.05).Logistic regression analysis demonstrated a diameter of hemangioma greater than 15 cm was a risk factor of intraoperative massive blood loss during surgical resection.Conclusions Giant hepatic hemangioma may cause disorders in the hematological and coagulation systems.Compression of major hepatic vessels raised technical difficulty and risks in surgery.Hemangioma with a diameter greater than 15 cm was recognized as a high-risk factor of intraoperative massive blood loss.
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BACKGROUNDS/AIMS: Liver hemangioma, the most common benign liver tumor, can be safely managed by clinical observation. However, surgical treatment should be considered in a subset of patients with giant hemangioma with abdominal symptoms. We reviewed the feasibility of total laparoscopic liver resection for giant hemangioma of >6 cm in diameter. METHODS: Nine consecutive patients who underwent total laparoscopic liver resection for giant hemangioma between August 2008 to December 2012 were included in this study. Medical records were retrospectively reviewed for demographic data, laboratory findings, and perioperative results. RESULTS: The median age of patients was 36 yrs (range, 31-63). Eight females and 1 male were included in the study. The median size of hemangioma was 11 cm in diameter (range, 6-18) and 5 patients had a hemangioma >10 cm. Indications for surgical treatments were abdominal symptoms in 4 patients, increased size in 5 patients, and uncertain diagnosis in 1 patient. The median operation time was 522 minutes for right hepatectomy, 220 minutes for left lateral sectionectomy, and 90 minutes for wedge resection. The median estimated blood loss was 400 ml (range, 50-900). There was no postoperative morbidity, including Clanvien-Dindo grade I. CONCLUSIONS: The resection of giant hemangioma demands meticulous surgical technique due to high vascularity and the concomitant risk of intraoperative hemorrhage. Laparoscopic liver resection is feasible with minimal operative complication. Therefore, laparoscopic liver resection can be considered as an option for surgical treatment for giant hemangioma.
Subject(s)
Female , Humans , Male , Diagnosis , Hemangioma , Hemorrhage , Hepatectomy , Liver , Medical Records , Retrospective StudiesABSTRACT
El llamado hemangioma hepático gigante suele ser menos frecuente que aquellos que miden menos de 5 cm, los primeros causan síntomas en algunos de los casos y mayor riesgo de complicaciones como la ruptura traumática, por lo que su manejo puede ser de cierta complejidad ya que en la actualidad no existe un consenso para su tratamiento. Se presentó una paciente femenina, de 18 años de edad, que consultó por presentar dolor y masa palpable en epigastrio. En los estudios imaginológicos realizados se constató un tumor en lóbulo hepático izquierdo compatible con hemangioma gigante, lo que se corroboró mediante videolaparoscopia donde se observó una imagen vascular atípica. Se discutió el caso en un equipo interdisciplinario formado por los servicios de gastroenterología, cirugía e imaginología, que decidió realizar inicialmente quimioembolización de la arteria hepática con Gel FOAM y, en un segundo tiempo, la resección quirúrgica de la lesión, lo que permitió mayor accesibilidad quirúrgica, evitó complicaciones, además de una evolución posquirúrgica favorable
The so called giant hepatic hemangioma is usually less frequent than those smaller than 5 cm. The first ones cause symptoms in some cases and they increased the risk of complications such as traumatic rupture; so that their management can be rather complex since currently there is no consensus for their treatment. A 18 year-old female patient was received at consultation due to pain and palpable mass in the epigastrium. In imaging studies performed a tumor was found in the left hepatic lobe, which was compatible with giant hemangioma. It was corroborated by videolaparoscopy which showed an atypical vascular imaging. This case was discussed in an interdisciplinary team of the gastroenterology, surgery and imaging services. Chemoembolization to hepatic artery was initially decided with Gel FOAM and, in a second stage, surgical resection of the lesion was performed, which allowed greater surgical accessibility, avoiding complications, along with a positive surgical outcome
Subject(s)
Humans , Female , Adolescent , Hemangioma/surgery , Hemangioma , Liver Neoplasms/surgeryABSTRACT
Kasabach-Merritt syndrome (KMS) consists of thrombocytopenia, microangiopathic hemolytic anemia, and localized consumption coagulopathy that develops within vascular hemangioma. This syndrome may also be associated with occult hemangiomas located at various sites. Tc-99m RBC scintigraphy and SPECT have proven to be reliable for confirming or excluding hemangioma. Total body blood pool imaging study during the scintigraphy also provides a means of screening for occult lesions. The authors report the case of a 29-year-old man who presented with a giant hepatic hemangioma complicated by KMS, and underwent Tc-99m RBC scintigraphy and SPECT including a total body blood pool imaging study.