A fistula on the cavernous hemangioma on the liver is close to the main blood vessel, how to treat it without removing it?

Patient: Examination and laboratory tests: On June 28, 2011, ultrasound of the liver showed that there was a shadow, which was suspected to be a tumor, and on June 30, an enhanced CT showed that it was a spongy hemangioma, like the size of a ping-pong ball, which was very close to the main blood vessel of the liver. Treatment: On September 20, 2011, a minimally invasive interventional surgery was performed to instill medication into the blood vessel of the tumor, and a fistula was found at one end of the hemangioma, so the surgeon had to instill only a small amount of medication. The surgeon had to put in only a small amount of medicine. He told me to go for a checkup after 3 months, but I have not had a checkup so far. Medical history: prenatal billet in the baby, parents and I do not know, characterized by a birthmark on the left arm, left thigh there is a birthmark on the outside of the left thigh, no pain, no itch. 2011 June examination of internal organs found on the liver. As mentioned above. What are the conservative treatments to preserve life without surgical removal of the fistula and for how many years? Is there any previous precedent of the same patient? Henan Provincial People’s Hospital Interventional Department Cao Guang Shao patient: medical records are like the above examination and laboratory tests described. Henan Provincial People’s Hospital Interventional Cao Guang Shao: First of all, you do not have to worry too much about this, even without any treatment, there is basically no life-threatening possibility, our department to see the liver hemangioma patients in this kind of patient is really quite a lot. The tumor grows to a certain size, it is likely to be combined with the arterio-portal fistula, etc., the intervention only needs to be plugged with embolism agent fistula mouth blockage, and then use iodine oil plus pingyangmycin embolization of hemangiomas. If the embolization is not ideal in this way, after four or five days, under the guidance of CT, a fine needle can be used to puncture directly to the embolization defect area, and the blood in the defect area will be drawn out first, and then injected with additional drugs to achieve perfect embolization. In addition, hepatic hemangioma is a packet of blood sinusoids, which is a vascular malformation rather than a tumor, and is usually asymptomatic unless there are symptoms of compression or involvement of the peritoneum, with the risk of rupture and bleeding. Generally speaking, only those larger than 5cm in the liver parenchyma or larger than 3cm near the edge of the liver (the larger and closer to the pericardium, the more likely to rupture and bleed, but to be honest, the chances of occurrence are relatively low) or symptomatic will be given treatment. In the past, conventional surgical resection was performed, but it was traumatic, had many complications, and could not be removed if it was multiple or in an important area such as the hepatic hilum. Nowadays, with interventional surgery, only a small tube is inserted into the femoral artery at the root of the thigh, with a small cotton swab-sized opening, without incision, the catheter is sent to the blood-supplying artery of the hepatic hemangioma, and medication is injected to drive the blood inside the hemangioma to the surrounding normal liver tissues, and destroying the hemangioma endothelial cells so that the hemangioma will form a scar, which will be slowly reduced, and finally form a scar or calcified foci, which will eliminate the risk of bleeding, and achieve the therapeutic purpose. Generally only need to stay in hospital for about one week, after the operation, only need to lie flat on the bed for one day and one night, the next day when you get down to the ground, basically you can’t see the puncture point, after five days liver function recovery, you can be discharged from the hospital, and after three months to review the CT of liver to know the shrinkage of hemangioma.