Torsion of a giant pedunculated liver hemangioma: Case report
| Autor: | Stefanie Campos Medina, Yeray Trujillo Loli, Llenner Castañeda Puicón |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Liver tumor Iliac fossa 030230 surgery Asymptomatic Cavernous hemangioma Hemangioma 03 medical and health sciences 0302 clinical medicine Case report medicine cardiovascular diseases business.industry Torsion (gastropod) Hepatic hemangioma Pedunculated giant hemangioma medicine.disease eye diseases body regions medicine.anatomical_structure 030220 oncology & carcinogenesis Liver Hemangioma Surgery sense organs Radiology Differential diagnosis medicine.symptom Presentation (obstetrics) business Liver tumors |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| DOI: | 10.1016/j.ijscr.2020.09.077 |
| Popis: | Highlights • Torsioned pedunculated giant liver hemangioma should be considered in the differential diagnosis of acute appendicitis. • Giant liver hemangioma size may be related to the elevation of liver enzymes. • Surgery is the first-line treatment in patients with giant liver hemangioma. Introduction Hepatic hemangioma (HH) is the most common benign neoplasm affecting the liver. Most cases are asymptomatic and incidentally found at imaging studies. Giant hepatic hemangiomas are uncommon, but pedunculated giant hemangiomas are even rarer, making their clinical and imaging diagnosis a challenge for the surgeon. Presentation of case Herein; we report the case of a 26-year-old male patient, who presented to the emergency ward with acute abdominal pain associated with a palpable mass, mimicking a complicated appendicular plastron, additionaly were found it liver enzymes elevated. Then the patient was taken the operating room. An exophytic pedunculated liver tumor that projected towards the right iliac fossa was identified. It had undergone torsion on its pedicle. Transfixing hemostatic sutures were placed, proceeding with its exeresis. The patient tolerated the procedure and was discharged without complications on the third postoperative day. Pathological anatomy confirmed the diagnosis. Discussion Giant pedunculated HH is an infrequent entity that generates mass effect on intra-abdominal organs causing pain depending on its location. In our case, HH size was 13 cm with elevated liver enzymes, only previously reported in one case of a 20-cm hemangioma. Surgery is indicated for cases of giant and symptomatic lesions. Conclusion Torsioned pedinculated giant liver hemangioma may be part of the differential diagnosis of a patient with acute appendicitis with elevated liver enzymes. The elevation of liver enzymes may be related to the size of the HH. |
| Databáze: | OpenAIRE |
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