19Feb

Hemangioma - how to diagnose and treat?

Hemangioma - red formation on the skin

Hemangioma - red formation on the skin

Hemangioma of the liver is a benign tumor that is formed from the vessels in the liver tissues.

It is clear from the definition that the disease is not cancer, therefore, it is not so dangerous. Nevertheless, there are specific features and their dangers associated with hemangioma, therefore, it is also not worth while to leave this disease without attention.

Table of contents:

  1. Classifications of
  2. Cavernous hemangioma of liver
  3. Reasons for the appearance of hemangioma
  4. Symptoms of hemangioma
  5. Other complications of hemangioma
  6. Treatment of hemangioma

Classifications

Classification of hemangiomas

Classification of hemangiomas

Hemangiomas of the liver are not all the same. Common to all hemangiomas is that they develop from evolved endothelial cells. Endothelium is an internal cellular lining of blood vessels, their inner membranes.

Hemangiomas can develop from different types of vessels, and, according to this, different types of hemangiomas are distinguished.

  • Capillary - reminiscent of the shape of the berry. Often, hemangiomas of this type are formed on the face. It has a cavity, sometimes even a separate vein supplies it. Rarely reach large sizes and are almost completely safe.
  • Cavernous - it's more dangerous. The structure of such a hemangioma is heterogeneous, it consists of a voluminous cavity and large vessels feeding it, as a rule, these are large arteries.

Cavernous hemangioma of the liver

Let's take a closer look at the structure of this particular type, since it is cavernous, and not capillary, liver hemangioma that presents a more significant danger to the patient.

So, the cavernous hemangioma of the liver consists of:

  • Cavernous hemangioma of the liver

    Cavernous hemangioma of the liver

    Cavities, single or multicameral;this cavity is filled with blood coming from the vessels feeding

  • vessels of the Endothelial wall lined with usual, unchanged endothelial cells
  • Fibrous wall follows the thin endothelial lining and performs a shaping and protective function protecting the tumor from damage

Cavernous hemangioma is one of the most dangerous typesinternal localizations. And the most insidious.

Appearing as it was said above, almost in infancy, the tumor gradually expands, not manifesting itself in any way. At the same time, it becomes more and more filled with blood, the fibrous wall that holds its contents gradually expands. And at any time it can burst, causing massive internal bleeding, which poses a serious threat to the life of the patient.

Causes of the appearance of hemangioma

Causes of hemangioma

Causes of the development of hemangioma

In most cases, the development of hemangioma begins in infancy, and further, it only becomes more noticeable, although a person can live a lifetime without even suspecting that he has hemangioma of the liver.

The causes of hemangioma are still unknown. Most often, its appearance is associated with a simple anomaly of vascular development.

Symptoms of liver hemangioma

Drawing in the abdomen

Drawing pain in abdomen

It all depends on its location, whether it squeezes any adjacent tissues, important vessels or bile ducts. If the hemangioma is located successfully, the symptomatology is completely absent. A person lives quietly, without suffering from any of its manifestations.

Sometimes hemangioma( with its large size) can be manifested by drawing pain in the area of ​​the projection of the liver, increasing liver size during physical and instrumental examination.

However, the hemangioma of any internal site is fraught with a latent danger and can immediately manifest itself as internal bleeding for blunt injuries to the abdomen or musculoskeletal system.

The peculiarity of bleeding of their hemangiomas is that it is extremely difficult to stop, since the blood supply of the tumor is rich, the vasculature feeding it is very developed and the doctors often have too little time to help the patient.

Other complications of hemangioma

Complications of hemangioma In addition to the risk of bleeding, clots can also form in the hemangiomas.

Since the tumor cavity is often quite large, in( cases where the hemangioma diameter was 20 cm are known), especially for cavernous hemangioma, the "consumption" of platelets in thrombosis in such a cavity is very large. In this regard, it can cause severe thrombocytopenia and negatively affect the process of normal blood clotting where necessary: ​​with cuts, other external injuries.

Treatment of hemangioma of liver

Preliminary diagnosis and size determination

Preliminary diagnosis and determination of

size When detecting hemangioma of the liver, doctors often face a dilemma: treat it or not treat it. Where does this question come from? The fact is that the nutrition of the neoplasm often occurs from several arterial vessels, and, consequently, the intervention on such a tumor is fraught with a serious risk of bleeding.

In this regard, before treating hemangioma of the liver, the doctor should evaluate its size, rapid growth and the risk of rupture. In some cases, an involution of the neoplasm is possible. And then the doctors advise simply to wait and "observe" the dispensary records.

Even criteria for assessing the risk of hemangioma for the patient were derived. So, the hemangioma should be treated if:

  • Its diameter exceeds 5 cm and there is a tendency to its growth
  • It squeezes adjacent organs or vessels
  • Causes discomfort, pulling pains in the right side of the patient
  • Hormone therapy, planned pregnancy( because these factorsincrease the size of the tumor)
Surgery

Surgical treatment

If the doctor decides that the tumor is dangerous and should be treated, the cryodestruction method or treatment is most often used in such casese laser. A possible complication after that treatment is scar formation on liver tissue.

Another, older method is surgical treatment-liver resection. This is a vast, rather complex surgical intervention. Depending on the volume, the areas of the liver that had to be removed along with the neoplasm are differentiated:

  • Right-side hemihepatectomy( removal of half of the liver)
  • Left-side hemihepatectomy
  • Trisegmentectomy( removal of 3 anatomical segments of the liver)
  • Bisegectomy( removal of 2 anatomical segments of the liver)
  • Segmentation1st anatomical segment of the liver)
  • Atypical edge resection of the liver
  • Enucleation of the hemangioma

These terms sound complicated and intimidating, butThe essence of the operation is simple - the surgeon simply removes the tumor together with the part of the liver in which it was formed. The volume of necessary resection is determined by the volume of the tumor itself.

The technique of puncture sclerotherapy of hemangioma was also widely used. For this purpose, suspensions or solutions of ferromagnets are used. Such treatment is often prescribed after a previously performed hepatic artery ligation( in order to "de-energize" the nutrition of the tumor).

The most modern variant of such treatment is percutaneous stress-directed targeted puncture with the introduction of a sclerosing drug under the control of sonography.

Local embolization with ferromagnets through laparotomy is also used. All these treatment options, as a rule, show excellent results and are selected depending on the location, size and blood supply of the tumor.

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