Buscar en
Gastroenterología y Hepatología
Toda la web
Inicio Gastroenterología y Hepatología Manejo terapéutico de la hemorragia espontánea hepática debido a una hiperpla...
Journal Information
Vol. 30. Issue 7.
Pages 387-390 (August 2007)
Share
Share
Download PDF
More article options
Vol. 30. Issue 7.
Pages 387-390 (August 2007)
Observaciones clínicas
Full text access
Manejo terapéutico de la hemorragia espontánea hepática debido a una hiperplasia nodular focal
Management of spontaneous hepatic hemorrhage due to focal nodular hyperplasia
Visits
6613
Teófilo Cubo Cintasa, David Padilla-Valverdea,
Corresponding author
marcote15@yahoo.es

Correspondencia: Dr. D. Padilla-Valverde. Urb. Los Girasoles, 16. 1.ª Fase. 13005 Ciudad Real. España.
, Pedro Villarejo Camposa, Antonio López Userosa, Carmen Manzanares Campilloa, Francisco Martínb, Miguel A. Zarcac
a Servicio de Cirugía General y Aparato Digestivo. Hospital General. Ciudad Real. España
b Servicio de Anatomía Patológica. Hospital General. Ciudad Real. España
c Servicio de Radiología. Hospital General. Ciudad Real. España
This item has received
Article information
Resumen

La hiperplasia nodular focal constituye una lesión hepática benigna, cuya evolución habitualmente es asintomática. Su presentación como hemorragia hepática espontánea es excepcional y habitualmente aparece en lesiones hepáticas, como el carcinoma y el adenoma hepatocelular. Presentamos el caso de una mujer con rotura espontánea intralesional de una hiperplasia nodular focal, con hemorragia hepática, tratada tras una estabilización hemodinámica mediante embolización selectiva arterial, para posteriormente realizar la resección hepática, debido a la excepcionalidad en el inicio clínico de la hiperplasia nodular focal, y la intención de actualizar el manejo terapéutico de estas lesiones con la embolización transarterial hepática.

Focal nodular hyperplasia is a benign liver tumor that usually follows an asymptomatic course. Hemorrhage of hepatic focal nodular hyperplasia is exceptional and occurs in tumors such as hepatocellular carcinoma and hepatic adenoma. We report the case of a woman with spontaneous rupture and hemorrhage of focal nodular hyperplasia. Hemodynamic stabilization was achieved by selective hepatic arterial embolization. Elective hepatic resection was subsequently performed. This clinical course is extremely rare. We describe the therapeutic management of these complications using hepatic transarterial embolization, which could avoid potentially harmful aggressive treatments.

Full text is only aviable in PDF
Bibliografía
[1.]
Y.T. Becker, D.S. Raiford, L. Webb, J.K. Wright, W.C. Chapman, C.W. Pinson.
Rupture and hemorrhage of hepatic focal nodular hyperplasia.
Am Surg, 61 (1995), pp. 210-214
[2.]
V.J. Casillas, M.A. Almendola, A. Gascue, N. Pinnar, J.U. Levi, J. Pérez.
Imaging of nontraumatic hemorrhagic hepatic lesions.
[3.]
J. Hardwigsen, J. Pons, V. Veit, S. García, Y.P. Le Treut.
A life threatening complication of focal nodular hyperplasia.
J Hepatol, 35 (2001), pp. 310-312
[4.]
M. Behrend, P. Flemming, H.J. Halbfass.
Spontaneous bleeding of focal nodular hyperplasia as a rare cause of acute abdomen.
Chirug, 72 (2001), pp. 1201-1204
[5.]
A. Kleespies, U. Settmacher, P. Neuhaus.
Spontaneus rupture of hepatic focal nodular hyperplasia-a rare cause of intraabdominal bleeding.
Zentralbl Chir, 127 (2002), pp. 326-328
[6.]
A. Rahili, J. Cai, C. Trastour, A. Juwid, D. Benchimol, M. Zheng, et al.
Spontaneous rupture and hemorrhage of hepatic focal nodular hyperplasia in lobus caudatus.
J Hepatobiliary Pancreat Surg, 12 (2005), pp. 138-142
[7.]
S.K. Chang, Y.F. Cheng, C.H. Thng, H.W. Loo.
Focal nodular hyperplasia presenting as acute abdomen.
Singapore Med J, 46 (2005), pp. 90-92
[8.]
B.N. Nguyen, J.F. Flejou, B. Tenis, J. Belghiti, C. Degott.
Focal nodular hyperplasia presenting of the liver: a compresive pathologic study of 305 lesions and recognition of new histologics forms.
Am J Surg Pathol, 23 (1999), pp. 1441-1454
[9.]
I.R. Wanless, C. Mawdsley, R. Adams.
On the pathogenesis of focal nodular hyperplasia of the liver.
Hepatology, 5 (1985), pp. 1194-1200
[10.]
V. Paradis, I. Bieche, D. Dargere, I. Laurendeau, J. Nectoux, C. Degott, et al.
A quantitative gene expression study a role for angiopoietins in focal nodular hyperplasia.
Gastroenterology, 124 (2003), pp. 651-659
[11.]
A. Weimann, B. Ringe, J. Klempnauer, P. Lamesch, K.F. Gratz, M. Prokop, et al.
Benign liver tumor: differential diagnosis and indications for surgery.
World J Surg, 21 (1997), pp. 983-991
[12.]
J. Kim, S.A. Ahmad, A.M. Lowy, J.F. Buell, L.J. Pennigton, S.J. Moulton, et al.
An algorithm for the accurate identification of benign liver lesions.
Am J Surg, 187 (2004), pp. 274-279
[13.]
S.K. Carlson, C.D. Jonson, C.E. Beuder, T.J. Welch.
CT of focal nodular hyperplasia of the liver.
[14.]
S.M. Hussain, T. Terkivatan, P.E. Zondervan, E. Lanjow, S. De Rave, J.N. Ijzermans, et al.
Focal nodular hyperplasia: findings at state of the art MR imaging, US, CT and pathologic analysis.
Radiographics, 24 (2004), pp. 3-17
[15.]
V. D’Halluin, V. Vilgrain, G. Pelletier, L. Rocher, J. Belguita, S. Erlinger, et al.
Evolution naturelle del’hyperplasie nodulaire focal: étude rétrospective de 44 cas.
Gastroenterol Clin Biol, 25 (2001), pp. 1008-1010
[16.]
D. Cherqui, A. Rahmouni, F. Charlotte, H. Boulahdour, J.M. Metrea, M. Meignau, et al.
Management of focal nodular hyperplasia and hepatocellular adenoma in young women: a series of 41 patients with clinical, radiological and pathological correlations.
Hepatology, 22 (1995), pp. 1674-1681
[17.]
T. Terkivatan, J.H.W. De Kilt, R.A. De Man, R.R. Van Rijn, P.E. Zondervan, H.W. Tilanus, et al.
Indications and long term outcome of treatment for benign hepatic tumors.
Arch Surg, 136 (2001), pp. 1033-1038
[18.]
J.A. Pain, A.E. Gimson, R. Williams, E.R. Howard.
Focal nodular hyperplasia of the liver: results of treatment and options in management.
Gut, 32 (1991), pp. 524-527
[19.]
Y. Fukukura, O. Nakashima, A. Kusaba, M. Kage, M. Kojiro.
Angioarchitecture and blood circulation in focal nodular hyperplasia o the liver.
J Hepatol, 29 (1998), pp. 470-475
[20.]
T. Terkivatan, S.M. Hussain, J.S. Lameris, J.N.M. Ijzermans.
Transcatheter arterial embolization as a safe and effective treatment for focal nodular hyperplasia of the liver.
Cardiovasc Intervent Radiol, 25 (2002), pp. 450-453
[21.]
J.F.H. Geschwind, M.S. Degli, J.M. Morris, M.A. Chota.
Treatment of focal nodular hyperplasia with selective transcathet arterial embolization using iodized oil and polyvinil alcohol.
Cardiovasc Intervent Radiol, 25 (2002), pp. 340-341
[22.]
M.H. Núñez-Rodríguez, H. Calero, R. Velicia-Llames, F. García-Pajares, G. Sánchez-Antolín, A. Caro-Patón.
Symptomatic hepatic arterioportal shunt resolved through conservative treatment.
Gastroenterol Hepatol, 29 (2006), pp. 237-239
[23.]
A. Ríos-Zambudio, A. Capel-Alemán, M. Del Pozo-Rodríguez.
Massive lower gastrointestinal bleeding treated with superselective embolization.
Gastroenterol Hepatol, 27 (2004), pp. 345-346
Copyright © 2007. Elsevier España S.L.. Todos los derechos reservados
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos