A 44-year-old man, who was diagnosed with a gastrointestinal stromal tumor incidentally during emergency laparotomy for treatment of acute obstruction of small intestine at another hospital in 1999, was referred to ou...A 44-year-old man, who was diagnosed with a gastrointestinal stromal tumor incidentally during emergency laparotomy for treatment of acute obstruction of small intestine at another hospital in 1999, was referred to our hospital due to a solitary metastasis in the liver in November 2002. A right segmentectomy (Segment 6, Couinaud's system) of liver was carried out. Half and one years later, a recurrent metastasis with involvement of the inferior vena cava was detected in posterior region of the liver. He underwent the third surgery in May 2004. Three another small metastases in greater omentum were found and removed. The tumor in posterior sector of the liver was en bloc resected with portion of involved inferior vena cava and diaphragm. The resected vena cava is repaired primarily through a lateral venorraphy.However, local recurrence was detected one year later, he recieved the fourth surgery in July 2005. He is now in Gleevec therapy. At present, he is in good health and free of recurrence.展开更多
Rupture of hepatocellular carcinoma associated with pregnancy is highly unusual. We report herein 3 cases found incidentally during emergency obstetric surgery. All the 3 patients were in their second or third trimest...Rupture of hepatocellular carcinoma associated with pregnancy is highly unusual. We report herein 3 cases found incidentally during emergency obstetric surgery. All the 3 patients were in their second or third trimester, had no history of contraceptive pill usage, and proved to have hepatitis B virus infection or liver cirrhosis. Ohe of patients had a history of blunt trauma, another patient presented as an acute abdomen. Hemostasis was achieved by suture plication and right hepatic artery ligation in 2 patients, and bisegmentectomy in another one. Live infants were delivered in 2 cases, another one was stable during the surgery and termination of the pregnancy was performed postoperatively. The maternal outcome was grave, 2 of the patients succumbed to aggressive hepatocellular carcinoma in a short time after the operation. A special challenge is imposed on the physician when confronted by this condition as 2 lives are involved.展开更多
文摘A 44-year-old man, who was diagnosed with a gastrointestinal stromal tumor incidentally during emergency laparotomy for treatment of acute obstruction of small intestine at another hospital in 1999, was referred to our hospital due to a solitary metastasis in the liver in November 2002. A right segmentectomy (Segment 6, Couinaud's system) of liver was carried out. Half and one years later, a recurrent metastasis with involvement of the inferior vena cava was detected in posterior region of the liver. He underwent the third surgery in May 2004. Three another small metastases in greater omentum were found and removed. The tumor in posterior sector of the liver was en bloc resected with portion of involved inferior vena cava and diaphragm. The resected vena cava is repaired primarily through a lateral venorraphy.However, local recurrence was detected one year later, he recieved the fourth surgery in July 2005. He is now in Gleevec therapy. At present, he is in good health and free of recurrence.
文摘Rupture of hepatocellular carcinoma associated with pregnancy is highly unusual. We report herein 3 cases found incidentally during emergency obstetric surgery. All the 3 patients were in their second or third trimester, had no history of contraceptive pill usage, and proved to have hepatitis B virus infection or liver cirrhosis. Ohe of patients had a history of blunt trauma, another patient presented as an acute abdomen. Hemostasis was achieved by suture plication and right hepatic artery ligation in 2 patients, and bisegmentectomy in another one. Live infants were delivered in 2 cases, another one was stable during the surgery and termination of the pregnancy was performed postoperatively. The maternal outcome was grave, 2 of the patients succumbed to aggressive hepatocellular carcinoma in a short time after the operation. A special challenge is imposed on the physician when confronted by this condition as 2 lives are involved.
