Conduta nos hemangiomas hepáticos / Management of hepatic hemangiomas

Authors

  • Edmundo Vieira Prado Neto Brazilian Journals Publicações de Periódicos, São José dos Pinhais, Paraná
  • Isabelle Audacio Ramos Fernandez
  • Paulo Ernesto Vidotto Talarico
  • Omar Batista Nunez
  • João Vitor Soares Vicentini
  • Roberto Tussi Junior
  • Mateus de Almeida Moreira da Silva
  • Benedito Pilon

DOI:

https://doi.org/10.34119/bjhrv5n2-093

Keywords:

hemangioma hepático, tratamento, fígado.

Abstract

O hemangioma hepático é o tumor hepático benigno mais comum na população. Na maioria dos casos, pequeno e assintomático. Morfologicamente, pode ser uma lesão avermelhada, bem delimitada, compressível à pressão digital. O hemangioma gigante (≥4 cm) pode ser sintomático ou romper. Rotineiramente, o diagnóstico é realizado primeiro por USG de abdome e, em seguida, confirmado em mais de 90% dos casos por tomografia computadorizada (TC) ou ressonância magnética nuclear (RM). O diagnóstico fortuito de tem se tornado muito frequente. Os autores buscam confrontar a conduta expectativa com a conduta intervencionista em hemangiomas hepáticos e comparar os desfechos dentre os métodos terapêuticos encontrados nesta respectiva revisão. Foi realizada busca nas bases de dados Pubmed, Embase, Bireme, Scielo e Cochrane. Foram encontrados 1447 textos que foram selecionados primeiramente através da leitura de título ou título e resumo, o que resultou em 165 artigos que foram lidos na íntegra. 37 dos 165 textos abordaram a temática do objetivo e, por isso, foram incluídos. Assim como a Revisão da Cochrane Library de 2007, o presente estudo não encontrou evidências de alto nível a partir desse período 2007-2017. Portanto, apresenta limitações. Não houve tratamento estatístico para os dados encontrados, o que também diminui o nível de evidência desta revisão. Hemangiomas hepáticos menor ou igual a 4 cm não causam sintomas. Portanto, não há indicação terapêutica. A maioria dos hemangiomas > 4 cm é assintomática e não manifesta complicações. Grande parte dos tumores tende a crescer, mas podem ser conduzidos seguramente por observação. Não há justificativa evidente para a intervenção cirúrgica preventiva, uma vez que a ruptura dos hemangiomas é um evento extremamente raro e, quando ocorre, a taxa de mortalidade atual é de 3,22%. O tratamento cirúrgico só é indicado quando ocorrem sintomas e/ou complicações.

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Published

2022-03-24

How to Cite

NETO, E. V. P.; FERNANDEZ, I. A. R.; TALARICO, P. E. V.; NUNEZ, O. B.; VICENTINI, J. V. S.; JUNIOR, R. T.; DA SILVA, M. de A. M.; PILON, B. Conduta nos hemangiomas hepáticos / Management of hepatic hemangiomas. Brazilian Journal of Health Review, [S. l.], v. 5, n. 2, p. 5073–5090, 2022. DOI: 10.34119/bjhrv5n2-093. Disponível em: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/45537. Acesso em: 28 mar. 2024.

Issue

Section

Original Papers