Endoscopic Treatment of Duodenal Bleeding Caused by Direct Hepatocellular Carcinoma Invasion with an Ethanol Injection
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
We report a case of a man who developed duodenal bleeding caused by direct hepatocellular carcinoma (HCC) invasion,which was successfully treated with endoscopic ethanol injection. A 57-year-old man with known HCC was admitted for melena and exertional dyspnea. He had been diagnosed with inoperable HCC a year ago. Urgent esophagogastroduodenoscopy (EGD) showed two widely eroded mucosal lesions with irregularly shaped luminal protruding hard mass on the duodenal bulb. Argon plasma coagulation and Epinephrine injection failed to control bleeding. We injected ethanol via endoscopy to control bleeding two times with 14 cc and 15 cc separately without complication. Follow-up EGD catched a large ulcer with necrotic and sclerotic base but no bleeding evidence was present. He was discharged and he did relatively well during the following periods. In conclusion,Endoscopic ethanol injection can be used as a signifi cantly effective and safe therapeutic tool in gastrointestinal tract bleeding caused by HCC invasion.
Abstract
We report a case of a man who developed duodenal bleeding caused by direct hepatocellular carcinoma (HCC) invasion,which was successfully treated with endoscopic ethanol injection. A 57-year-old man with known HCC was admitted for melena and exertional dyspnea. He had been diagnosed with inoperable HCC a year ago. Urgent esophagogastroduodenoscopy (EGD) showed two widely eroded mucosal lesions with irregularly shaped luminal protruding hard mass on the duodenal bulb. Argon plasma coagulation and Epinephrine injection failed to control bleeding. We injected ethanol via endoscopy to control bleeding two times with 14 cc and 15 cc separately without complication. Follow-up EGD catched a large ulcer with necrotic and sclerotic base but no bleeding evidence was present. He was discharged and he did relatively well during the following periods. In conclusion,Endoscopic ethanol injection can be used as a signifi cantly effective and safe therapeutic tool in gastrointestinal tract bleeding caused by HCC invasion.
참고문헌 (12)
- Yamada K, "Direct duodenal invasion of hepatocellular carcinoma. Intestinal hemorrhage treated by transcatheter arterial embolization", Clin Imaging, 22, pp.196~199 (1998)
- Cosenza CA, "Metastasis of hepatocellular carcinoma to the right colon manifested by gastrointestinal bleeding", Am Surg, 65, pp.218~221 (1999)
- Chen CY, "Lower gastrointestinal bleeding from a hepatocellular carcinoma invading the colon", J Clin Gastroenterol, 25, pp.373~375 (1997)
- Okusaka T, "Hepatocellular carcinoma with gastrointestinal hemorrhage caused by direct tumor invasion to the duodenum", Jpn J Clin Oncol, 27, pp.343~345 (1997)
- Lin CP, "Gastrointestinal metastasis in hepatocellular carcinoma: radiological and endoscopic studies of 11 cases", J Gastroenterol Hepatol, 15, pp.536~541 (2000)
- Anthony PP, "Primary carcinoma of the liver: a study of 282 cases in Ugandan Africans", J Pathol, 110, pp.37~48 (1973)
- Chen LT, "Gastrointestinal tract involvement in hepatocellular carcinoma: clinical, radiological and endoscopic studies", Endoscopy, 22, pp.118~123 (1990)
- Singh Kalra TM, "Hepatoma presenting as lower gastrointestinal bleeding", Am J Gastroenterol, 67, pp.485~488 (1977)
- Hung HC, "Radiotherapy in the treatment of duodenal bleeding due to hepatocellular carcinoma invasion", J Gastroenterol Hepatol, 13, pp.1143~1145 (1998)
- Orlando A, "Radiofrequency thermal ablation vs. percutaneous ethanol injection for small hepatocellular carcinoma in cirrhosis: meta-analysis of randomized controlled trials", Am J Gastroenterol, 104, pp.514~524 (2009)
- Livraghi T, "Percutaneous ethanol injection in the treatment of hepatocellular carcinoma in cirrhosis", Hepatogastroenterology, 48, pp.20~24 (2001)
- Shiina S, "Percutaneous ethanol injection therapy for hepatocellular carcinoma. A histopathologic study", Cancer, 68, pp.1524~1530 (1991)