误诊为腹水的肝癌局限性破裂出血36例临床分析

Clinical Analysis of 36 Hepatocellular carcinioma with Limited Rupture Hemorrhage

目的 :探讨原发性肝癌发生局限性破裂出血的CT表现、早期诊断及治疗。方法 :回顾性分析我院 36例手术证实为肝癌局限性破裂出血的患者的临床资料。结果 :36例患者术前CT误诊为腹水 ,35例存在上腹痛史 ,33例行手术切除 ,35例为肝细胞癌 ,36例肝肿瘤位于肝表面。结论 :CT检查肝癌靠近于肝脏表面 ,肿瘤周围有局限性低密度区 ,临床上最近有上腹疼痛或腹部剧痛史 ,以往曾有乙型肝炎病史或HBsAg阳性 ,应考虑为肝癌局限性破裂出血的可能。能手术切除者应尽力切除 ,不能手术切除者应采用经皮肝动脉栓塞化疗或肝动脉结扎术 。

Objective:To investigate CT manifestation of liver cancer with limited rupture hemorrhage for early diagnosis and timely therapy.Methods:Retrospective analysis of 36 cases of liver cancer with limited rupture bleeding which were proved by operation in our hospital.Results:CT reported 36 cases as ascites before operation. 35 cases had upper abdominal pain. 33 cases received surgical resection. 35 case were hepatocellular carcinomas. All liver tumors located at the surface.Conclusion:A patient with abdominal pain even severe pain and localized hypointense zone at the surface of liver tumor, which is at the surface of liver, should be considered as limited rupture bleeding of liver cancer and should be treated as early as possible.