Preoperative transcatheter arterial embolization for giant cavernous hemangioma of the liver with consumption coagulopathy
Suzuki, H.; Nimura, Y.; Kamiya, J.; Kondo, S.; Nagino, M.; Kanai, M.; Miyachi, M.
American Journal of Gastroenterology 92(4): 688-691
1997
ISSN/ISBN: 0002-9270 PMID: 9128326 Document Number: 475245
We describe a 40-yr-old woman with a giant hepatic hemangioma and consumption coagulopathy who underwent transcatheter arterial embolization (TAE) prior to liver resection. Post-contrast computed tomography showed a large mass in the right hepatic lobe with a peripheral, nodular enhancement pattern that enlarged on delayed-phase images. There was a low fibrinogen concentration and decreased platelet count. The patient received i.v. nafamostat mesilate and underwent selective embolization of the arteries feeding the hemangioma; consequently, the plasma fibrinogen concentration increased to 1.6-fold before surgery. Right hepatic lobectomy with partial resection of the caudate lobe was performed. The intraoperative blood loss was only 1380 g. This patient illustrates the usefulness of preoperative TAE for hepatic hemangioma with consumption coagulopathy; TAE appears to improve coagulopathy and increase the safety of surgery.