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Emergent orthotopic liver transplantation for hemorrhage from a giant cavernous hepatic hemangioma: case report and review.
Vagefi, Parsia A; Klein, Ingo; Gelb, Bruce; Hameed, Bilal; Moff, Stephen L; Simko, Jeff P; Fix, Oren K; Eilers, Helge; Feiner, John R; Ascher, Nancy L; Freise, Chris E; Bass, Nathan M.
Afiliación
  • Vagefi PA; Division of Transplant Surgery, University of California, San Francisco, San Francisco, CA 94143, USA. parsia.vagefi@ucsfmedctr.org
J Gastrointest Surg ; 15(1): 209-14, 2011 Jan.
Article en En | MEDLINE | ID: mdl-20549381
INTRODUCTION: Cavernous hemangiomas represent the most common benign primary hepatic neoplasm, often being incidentally detected. Although the majority of hepatic hemangiomas remain asymptomatic, symptomatic hepatic hemangiomas can present with abdominal pain, hemorrhage, biliary compression, or a consumptive coagulopathy. The optimal surgical management of symptomatic hepatic hemangiomas remains controversial, with resection, enucleation, and both deceased donor and living donor liver transplantation having been reported. CASE REPORT: We report the case of a patient found to have a unique syndrome of multiorgan cavernous hemangiomatosis involving the liver, lung, omentum, and spleen without cutaneous involvement. Sixteen years following her initial diagnosis, the patient suffered from intra-abdominal hemorrhage due to her giant cavernous hepatic hemangioma. Evidence of continued bleeding, in the setting of Kasabach-Merritt Syndrome and worsening abdominal compartment syndrome, prompted MELD exemption listing. The patient subsequently underwent emergent liver transplantation without complication. CONCLUSION: Although cavernous hemangiomas represent the most common benign primary hepatic neoplasm, hepatic hemangioma rupture remains a rare presentation in these patients. Management at a center with expertise in liver transplantation is warranted for those patients presenting with worsening DIC or hemorrhage, given the potential for rapid clinical decompensation.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Hígado / Cavidad Abdominal / Urgencias Médicas / Hemangioma Cavernoso / Hemorragia / Neoplasias Hepáticas Tipo de estudio: Diagnostic_studies / Etiology_studies Límite: Adult / Female / Humans Idioma: En Revista: J Gastrointest Surg Asunto de la revista: GASTROENTEROLOGIA Año: 2011 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Hígado / Cavidad Abdominal / Urgencias Médicas / Hemangioma Cavernoso / Hemorragia / Neoplasias Hepáticas Tipo de estudio: Diagnostic_studies / Etiology_studies Límite: Adult / Female / Humans Idioma: En Revista: J Gastrointest Surg Asunto de la revista: GASTROENTEROLOGIA Año: 2011 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos