J Korean Radiol Soc.  1989 Feb;25(1):18-23. 10.3348/jkrs.1989.25.1.18.

Transcatheter hepatic arterial embolization of ruptured hepatoma with massive intraperitoneal bleeding

Abstract

Intractable bleeding of ruptured hepatoma has worst prognosis because conservative treatment could not controlthe bleeding or because surgical therapy is difficult due to advanced cirrhosis or tumor. Transcatheter hepaticarterial embolization has been used effectively in controlloing traumatic bleeding & non-operative hepatoma. Inruptured hepatoma transcatheter hepatic arterial embolization could achiece not only bleeding control but alsopalliative treatment of hepatoma. We performed transcatheter hepatic arterial embolization in 26 cases of rupturedhepatoma from Mar. 1985 to Dec. 1988. The result are as follows. 1. Transcatheter hepatic arterial embolizationwas performed in 30 cases (5.7%) of ruptured hepatoma which included 4 cases of follow up loss, among the 525 hepatoma patient. 2. All patients were over 40 years lod. 3. Contrast extravasation was visualized in 4 cases(15%). 4. Nodular type of tumor with subcapsular exophytic growth was in 20 cases (77%), suspected as the site ofrupture. 5. Successful bleeding control was achieved in 23 cases (88%). 6. 13 cases (50%) were died within 2 weeks. The causes of death are hepatic encephalopathy, shock, and acute renal shut down. 7. The mean survival timeof 9 cases survived more than one month but died thereafter was 3.2 months. 8. 3 cases with the survival of morethan one year had subcapsular nodular tumor with no demonstrable portal vein invasion. Transcatheter hepaticarterial embolization is safe, effective, less invasive method for treatment of ruptured hepatoma with massiveintraperitoneal bleeding. We conclude that transcatheter hepatic arterial embolization is life saving procedure & treatment of choice for ruptured hepatoma.


MeSH Terms

Carcinoma, Hepatocellular*
Cause of Death
Fibrosis
Follow-Up Studies
Hemorrhage*
Hepatic Encephalopathy
Humans
Methods
Portal Vein
Prognosis
Shock
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