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.