Interventional Management of Subcapsular Hepatic Hematoma with Hepatic Compartment Syndrome After Laparoscopic Adrenalectomy
Interventional Management of Subcapsular Hepatic Hematoma with Hepatic Compartment Syndrome After Laparoscopic Adrenalectomy
复制标题
DOI：
10.1007/s00270-018-02158-6
复制
发表时间：
2019-04-01
影响因子：
2.9
通讯作者：
Lee, Woong Hee
中科院分区：
文献类型：
--
作者：
Lee, Hyoung Nam;Cho, Sung Gi;Lee, Woong Hee
肝室综合征是指肝内压升高，足以导致肝脏灌注受损。早期识别和及时治疗对于预防灾难性后果包括缺血性肝衰竭和低血容量性休克至关重要。这是一个罕见的病例，腹腔镜肾上腺切除术导致肝包膜下血肿合并肝筋膜室综合征。对比增强计算机断层扫描显示广泛的肝包膜下血肿伴门静脉和下腔静脉塌陷，提示即将发生的筋膜室综合征。诊断性导管血管造影术显示，从破裂的孤立动脉中有无数的点状外渗灶。急诊经皮导管减压和经动脉栓塞术均成功。
Hepatic compartment syndrome is an increase in intrahepatic pressure sufficient to cause compromised hepatic perfusion. Early recognition and prompt management are essential for preventing catastrophic consequences including ischemic liver failure and hypovolemic shock. This is the rare case of laparoscopic adrenalectomy resulting in subcapsular hepatic hematoma with hepatic compartment syndrome. Contrast-enhanced computed tomography demonstrated extensive subcapsular hepatic hematoma with collapse of portal vein and inferior vena cava suggesting impending compartment syndrome. Diagnostical catheter angiography of the liver revealed innumerable foci of petechial extravasation from disrupted isolated arteries. Emergent percutaneous catheter decompression and transarterial embolization were successful.