肝癌併自發性破裂出血之2階段肝臟腫瘤切除手術之一病例報告

Two-staged Hepatoectomy of Spontaneous Ruptured Hepatocellular Carcinoma-A Case Report

在台灣，肝癌台併自發性破裂而出血之病例報告並不常見。它是肝癌致命的併發症，發生率約為5.5%至26%。肝癌併發自發性破裂出血病患，會有突發性腹痛，並可能併有休克及貧血現象。腹部超音波會發現肝內腫瘤及腹水產生；腹腔穿刺可發現腹水富含血液物質。治療初期以止血為首要，絕大部份病患皆可作肝動脈血管栓塞術，以達到止血效果，如果腫瘤是局部性，而肝臟運作功能容許的話，做2階段肝臟腫瘤切除術是可行的。

Spontaneous rupture of a hepatecullar carcinoma is an uncommon but fatal disease entity in Taiwan, with an incidence of 5.5%-26%. Its clinical manifestations include sudden onset of severe abdomen pain, anemia and shock. Abdominal ultrasonography usually reveals intrahepatic tumor with ascites. Control of the tumor bleeding as soon as possible is the key point for prolonged survival. Transcatheter arterial embolization could be effective in achieving immediate hemostasis in most patients. Two-stage hepatoectomy is feasible in patients with limited tumor size and preserved liver function.