I. What is hepatic hemangioma.
Hepatic hemangioma is a relatively common benign tumor of the liver. Clinically, cavernous hemangioma is the most common, and patients mostly have no obvious symptoms of discomfort and are often found during ultrasound examination or during abdominal surgery. There is no evidence that it has the possibility of malignant transformation.
What are the symptoms of hepatic hemangioma?
Hepatic hemangioma mostly has no obvious discomfort symptoms, when the hemangioma increases to more than 125px, the following symptoms may appear.
1.Abdominal mass
The abdominal mass is cystic in nature, without pressure pain, with smooth or unsmooth surface, and conductive vascular murmur can be heard occasionally during auscultation at the mass site.
2.Gastrointestinal symptoms
Indistinct pain and/or discomfort in the right upper abdomen, loss of appetite, nausea, vomiting, belching, distention and fullness after eating, and other indigestion symptoms.
3.Compression symptoms
Huge hemangioma may push and compress the surrounding tissues and organs. Compression of lower esophagus may cause difficulty in swallowing; compression of extrahepatic bile duct may cause obstructive jaundice and gallbladder effusion; compression of portal vein system may cause splenomegaly and ascites; compression of lung may cause dyspnea and pulmonary atelectasis; compression of stomach and duodenum may cause gastrointestinal symptoms.
4.Rupture and bleeding of hepatic hemangioma
Rupture and bleeding of hepatic hemangioma may cause severe pain in the upper abdomen, as well as bleeding and shock symptoms. Most of the hepatic hemangiomas that grow below the rib cage rupture and bleed due to external force.
5.Kasabach-Merritt syndrome
Coagulation abnormalities caused by thrombocytopenia and massive consumption of coagulation factors. The pathogenesis of Kasabach-Merritt syndrome is the retention of blood in huge hemangioma, which consumes a large amount of red blood cells, platelets, coagulation factors II, V, VI and fibrinogen, causing abnormal coagulation mechanism, which may further develop into DIC.
6.Other
Necrosis may occur when a free extrahepatic growth of tipped hemangioma is twisted, resulting in severe abdominal pain, fever and deficiency. Individual patients with huge hemangioma accompanied by arteriovenous fistula formation may have increased return blood volume, leading to heart failure.
Treatment of hepatic hemangioma: Larger hemangiomas over 125px or those with symptoms generally need treatment.
1.Surgical treatment
At present, the treatment methods for hepatic hemangioma mainly include hemangioma resection, hemangioma suture, hepatic artery ligation, etc. Surgery is extremely traumatic and has a long recovery period, which I do not recommend for a benign tumor patient.
2.Interventional treatment
(1) Hepatic artery embolization (TAE)
TAE treatment for hepatic hemangioma is based on the fact that hepatic hemangioma is mainly supplied by hepatic artery, and thrombus can be formed in the tumor after embolization of artery. This patient was treated by this method and the tumor shrank significantly.
(2) Microwave and radiofrequency ablation treatment for hepatic hemangioma
Microwave curing of hepatic hemangioma and radiofrequency treatment, microwave can be converted into heat energy and cause the surrounding tissues to coagulate, causing local atrophy and hardening of the tumor to achieve the purpose of curing tumor. I recommend patients to further adopt local ablation treatment to completely and utterly remove the tumor.