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Journal of Medical Ultrasonics

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1999 - Vol.26

Vol.26 No.03

Case Report(症例報告)

(0119 - 0123)


Percutaneous Ethanol Injection Therapy for a Ruptured Hepatic Tumor: A Case in Which Therapy Stopped Intraabdominal Bleeding

岩田 郁1, 上原 祐子1, 喜多村 祐次1, 飯田 武史1, 富安 和光2, 新崎 厚史2, 上村 精一郎1

Kaoru IWATA1, Yuko UEHARA1, Yuji KITAMURA1, Takeshi IIDA1, Kazumitsu TOMIYASU2, Atsushi NIIZAKI2, Seiichiro KAMIMURA1

1福岡赤十字病院肝臓内科, 2福岡赤十字病院検査部

1Department of Internal Medicine, Fukuoka Red Cross Hospital, 3-1-1 Okusu, Minami-ku, Fukuoka-shi, 815-8555, Japan, 2Department of Clinical Laboratory, Fukuoka Red Cross Hospital, 3-1-1 Okusu, Minami-ku, Fukuoka-shi, 815-8555, Japan

キーワード : Percutaneous ethanol injection therapy, Percutaneous ethanol with lipiodol injection therapy (Lp-PEI) , Rupture of hepatic tumor

A 63-year-old man had previously been treated by a local clinician under the diagrosis of alcoholic liver cirrhosis. In October 1996 a hepatic tumor was found, and the patient was scheduled to be admitted to this institution at the beginning of January 1997. The patient was admitted for emergency treatment on 3 January 1997, however, because of severe anemia and epigastralgia accompanied by abdominal fullness. Hemoglobin level at time of admission was extremely low, and abdominal ultrasonography showed a large quantity of intraabdominal fluid and a 2-cm hypoechoic tumor with an area of low echo level. A diagnosis of ruptured hepatic tumor with intraabdominal bleeding was made. The patient was also found to have hepatic encephalopathy and poor hepatic reserve function. Emergency angiography followed by conservative therapy appeared inadequate to stop the bleeding from the hepatic tumor. We thus performed percutaneous ethanol injection therapy for hepatic tumor, mainly to stop the bleeding. The therapy successfully terminated the bleeding and saved the patient's life.