The diagnosis and therapy of intractable upper gastrointestinal hemorrhage caused by hepatic arterioportal vein fistulas in hepatocellular carcinoma
- VernacularTitle:肝癌合并肝动脉门静脉瘘导致顽固性上消化道出血的诊断和治疗
- Author:
Peng-Fei LUO
;
Xiao-Ming CHEN
;
Li-Gong LU
;
Bao-Shan HU
;
Yong LI
;
- Publication Type:Journal Article
- Keywords:
Carcinoma,hpatocellular;
Arterioportal fistula;
Hemorrhage;
Embolization,therapeutic
- From:
Chinese Journal of Radiology
2001;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the hemodynamics of increasing portal venous pressure(PVP) in hepatocellular carcinoma patients complicated with hepatic arterioportal vein fistulas (HAPVF)and the diagnosis and therapy of intractable upper gastrointestinal hemorrhage caused by HAPVF.Methods One hundred and fifteen cases of hepatocellular carcinoma with upper gastrointestinal hemorrhage were checked by hepatic arteriography and were treated through orifices embolization in cases with severe HAPCF by coils and/or ethanol. Results Twenty-six out of 31 patients suffering intractable upper gastrointestinal hemorrhage have severe HAPVF(the main stem of portal veins are visible).However,there are only 15 patients with light HAPVF among the 84 patients who have mild upper gastrointestinal hemorrhage (the main stem of portal veins are invisible).After the embolization,all of the 26 patients who have severe HAPVF stopped bleeding.Among them,the main stem of hepatic arteries are occluded in 2 patients. Conclusion The existence of severe HAPVF should be taken into consideration when intractable upper gastrointestinal hemorrhage occurs in hepatocellular carcinoma patients,and it can be diagnosed through hepatic artery DSA.Orifice embolization is the most effective method for such kind of hemorrhage.
