NHÂN MỘT TRƯỜNG HỢP U GAN THÙY ĐUÔI

Bệnh nhân T. 55 tuổi, Nữ.  Nghề nghiệp: nội trợ.  Địa chỉ: Củ Chi, TPHCM.  Đến Medic khám ngày: 01112022  Lý do khám: KTSK. BN đi siêu âm tình cờ phát hiện cấu trúc echo kém vùng đầu tụy > đến Medic khám lại. BN không đau bụng, không nôn ói, không chán ăn, không sốt.  Tiền căn bản thân: THA.  Tiền căn gia đình: mẹ bị xơ gan.  Thể trạng trung bình. Bụng mềm, ấn không điểm đau.

CASE REPORT NHÂN MỘT TRƯỜNG HỢP U GAN THÙY ĐUÔI BS TRẦN THỊ BẢO CHÂU KHOA SIÊU ÂM - MEDIC Bệnh án  Bệnh nhân T 55 tuổi, Nữ  Nghề nghiệp: nội trợ  Địa chỉ: Củ Chi, TPHCM  Đến Medic khám ngày: 01/11/2022  Lý khám: KTSK BN siêu âm tình cờ phát cấu trúc echo vùng đầu tụy -> đến Medic khám lại BN khơng đau bụng, khơng nơn ói, khơng chán ăn, không sốt  Tiền thân: THA  Tiền gia đình: mẹ bị xơ gan  Thể trạng trung bình Bụng mềm, ấn khơng điểm đau CT CT CT  BN qua BV Bình Dân BV Chợ Rẫy, tư vấn U mạch máu lành tính, khơng cần mổ Khơng làm thêm khác Theo dõi BÀN LUẬN  Hepatic hemangioma is the most common benign hepatic tumor  The caudate lobe, situated deeply in the liver, between the hepatic hila and inferior vena cava (IVC), is anatomically special which had made it hardly feasible to operate on it  According to reports domestic and overseas, isolated or combined caudate lobectomy is mainly the treatment of liver hemangioma, hepatocellular carcinoma (HCC), metastasis liver carcinoma, hilar hepatic cholangiocarcinoma (HCCA), hepatolithiasis in caudate lobe, etc Among all those hepatobiliary diseases, liver hemangioma in caudate lobe accounts for a large proportion  Even though hepatic hemangioma accounts for a great proportion of diseases of the caudate lobe, the incidence of hemangioma in the caudate lobe remains respectively small Surgical indication and strategy for liver hemangioma in the caudate lobe: a multi-institutional retrospective analysis with 137 patients  Published: 10 June 2020  In this study, totally 137 patients were treated in five large clinical centers in 25 years There are similar numbers of male (n = 73) (53.3%) and female (n = 64) patients (46.7%) with a gender ratio of 1.14:1, whose median age was 49.2 years  Of the 137 patients identified, 40 (29.20%) patients were asymptomatic, whereas other 94 patients had clinical symptoms mainly presented as upper abdominal discomfort, epigastric distention, upper abdominal dull pain, nausea, and vomiting Tumor diameter was obviously associated with the presence of clinical symptoms Non-operative treatment  Conservative treatment and follow-up in outpatient department is recommended to patients who presented no symptoms or those whose tumor is no more than 3 cm in diameter Surgical treatment  Operations were performed in patients with clinical features including upper abdominal discomfort, nausea and vomiting, epigastric distention, upper abdominal pain and abdominal mass, females preparing for pregnancy, and patients that could not be excluded from malignant disease by imaging examination In follow-up period, patients in the conservative group (n = 39) received surgery because of tumor growth or symptom appearance Totally 105 patients received operation including partial resection or isolated complete resection of caudate lobe and caudate lobe resection combined with liver segment resection, right liver resection, or left liver resection All operations went smoothly, and no severe complications appeared Surgical procedures  Of the 105 cases underwent surgery in the study, traditional surgical approaches were taken mainly by the year of 2010, and then laparoscopic caudate lobe resection and the approach guided by four surfaces of caudate lobe were gradually adopted after 2010 MEDIC CASE KẾT LUẬN  Đây trường hợp u mạch máu lớn gặp nằm vị trí thùy gan BN khơng có triệu chứng -> theo dõi, chưa cần phẫu thuật  Khối u lớn gây khó khăn chẩn đốn, khó xác định thuộc quan Cần phân tích hình ảnh để khẳng định loại trừ Nhờ CT phương tiện CLS khác giúp xác định chẩn đoán TÀI LIỆU THAM KHẢO https://wjso.biomedcentral.com/articles/10.1186/s12957-02001901-z https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8316955/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4572320/ https://www.ultrasoundmedicvn.com/2014/03/case-242-ivc-tumordr-phan-thanh-hai-dr.html CASE REPORT XIN CHÂN THÀNH CẢM ƠN! ... the approach guided by four surfaces of caudate lobe were gradually adopted after 2010 MEDIC CASE KẾT LUẬN  Đây trường hợp u mạch m? ?u lớn gặp nằm vị trí thùy gan BN khơng có tri? ?u chứng -> theo... complications appeared Surgical procedures  Of the 105 cases underwent surgery in the study, traditional surgical approaches were taken mainly by the year of 2010, and then laparoscopic caudate lobe resection... small Surgical indication and strategy for liver hemangioma in the caudate lobe: a multi-institutional retrospective analysis with 137 patients  Published: 10 June 2020  In this study, totally