What is hemorrhage caused by liver cancer? How to treat hemorrhage caused by liver cancer?

Liver cancer is a very dangerous disease and a malignant tumor with a high mortality rate. In the middle and late stages of liver cancer, bleeding often occurs. If not treated in time, it will seriously threaten the patient's life. Therefore, it is necessary to understand the causes and solutions of liver cancer bleeding in advance. Let's take a look at the details below!

What causes bleeding in liver cancer?

Hepatocellular carcinoma bleeding is common in nodular and mass-type liver cancers, especially in advanced cases with liver cirrhosis, where the bleeding tendency is more serious. There are two types of hepatocellular carcinoma rupture bleeding:

1. Subcapsular bleeding. This type of bleeding is often caused by cancer cells penetrating the capsule into the abdominal cavity. Once subcapsular bleeding occurs, the patient will experience severe upper abdominal pain and symptoms accompanied by acute bleeding and peritonitis. The disease deteriorates rapidly and the mortality rate is very high.

2. Rupture and bleeding of abdominal wall varicose veins:

Before the onset of the disease, the first symptoms are often hepatosplenomegaly, subcutaneous hemorrhage, gastrointestinal bleeding, and varicose bleeding in the gastric fundus and abdominal cavity. If the varicose veins are small, the bleeding is slow and the amount of bleeding is small. If the rupture is large, a large amount of bleeding often occurs, and the patient can quickly go into shock, which seriously threatens the patient's life.

What to do if liver cancer bleeds? How to treat it?

1. Drug hemostasis

The main cause of bleeding in cirrhosis is severe portal hypertension, so the most important thing is to lower blood pressure, which can be taken orally with propranolol or intravenous infusion of posterior pituitary hormone, octapeptide vasopressin and somatostatin. At the same time, use hemostatic agents such as vitamin K, anlosan, 6-aminoacetic acid, antifibrinolytic aromatic acid and traditional Chinese medicine Bletilla striata powder, Callicarpa ovalis, etc.

2. Mechanical hemostasis

It is mainly a three-chamber two-balloon tube for compression hemostasis. Generally, the above drugs are used for hemostasis first. If there is no obvious effect and the patient cannot undergo surgery immediately, mechanical hemostasis can be selected. For example, placing the balloon in a suitable position can achieve the effect of hemostasis. When using it, it must be inflated first. If it is a gastric balloon, it is generally about 300 to 500 milliliters. If it is an esophageal balloon, it is about 200 to 400 milliliters. Because esophageal varices mostly originate from the gastric fundus vein, as long as the gastric fundus vein is compressed, the bleeding can be stopped. If the bleeding still cannot be effectively stopped, the inflation volume of the esophageal balloon should be increased. Some people also advocate injecting physiological saline plus 8 mg of norepinephrine into the gastric tube to shrink the gastric mucosal blood vessels, thereby taking effect on those who continue to bleed after balloon compression. To avoid damage to the compressed mucosa, the air should be deflated for 1-2 hours every 12 hours of compression. Compression hemostasis measures generally do not exceed 3 days. Those who still bleed after 3 days should consider taking other measures.

3. Endoscopic hemostasis

For patients who do not respond to conservative medical treatment, endoscopic sclerotherapy can be used. This method uses an endoscope to confirm the bleeding site, and then embolization or thrombin spraying is performed to stop the bleeding. The hemostasis rate for acute bleeding is over 95%.

4. Surgical treatment

If the above three methods are not able to stop the bleeding, surgical treatment should be considered, including: ligation of the gastric fundus and esophageal varicose veins; transverse cutting of the gastric fundus and then gastro-gastric anastomosis; if the patient's general condition is still stable, portal vein or spleen and kidney vein anastomosis shunt surgery can be considered.