I had a liver hemangioma removed five years ago and it still hurts a lot. What should I do?

Written by Liu Wu Cai
Hepatobiliary Surgery
Updated on September 23, 2024
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If a patient still experiences pain five years after surgical removal of a liver hemangioma, attention should be paid, and further examinations should be completed to rule out other diseases.

Generally, patients with hemangiomas do not experience significant discomfort after removal, and there are no obvious sequelae. Therefore, if discomfort occurs, it is important to conduct thorough examinations as soon as possible to identify the cause and treat it accordingly. For instance, liver diseases like cirrhosis, hepatitis, and liver cancer can all manifest as upper right abdominal pain. At this point, it is necessary to differentiate among these causes and treat accordingly. If the patient has liver cancer, early surgical removal should be performed to achieve better treatment outcomes.

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Written by Li Hu Chen
Imaging Center
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Can liver hemangioma be definitively diagnosed by ultrasound?

If there is a hemangioma on the liver, it can generally be diagnosed through an ultrasound of the liver and biliary system. This is because hemangiomas have some characteristic appearances on ultrasound imaging. First, it's essential to understand the structure of the liver hemangioma which can be roughly considered as sponge-like, with a structure similar to a sponge containing many fine structures. When ultrasound is applied, this sponge-like structure will demonstrate strong echogenicity, appearing as a large mass with medium to strong echogenic responses. Thus, it is quite evident on ultrasound and has relatively high specificity, so it can generally be diagnosed through ultrasound. If the appearance is not typical, further examination with an enhanced CT scan can be carried out for diagnosis.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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Symptoms of deteriorating hepatic hemangioma

When deterioration occurs in liver blood vessels, it primarily manifests as rupture and bleeding of hepatic hemangiomas, which can lead to hemorrhagic shock, and even cause death. Of course, in the early stages of the disease, patients may only experience discomfort and pain in the upper right abdomen. As the bleeding increases, the pain becomes significant, and clinical symptoms such as decreased blood pressure and increased heart rate may occur. Therefore, it is important to pay close attention to patients with large hepatic hemangiomas and perform surgery as early as possible for a definitive cure. Moreover, postoperative attention is still needed. Patients should avoid injuries, follow a light diet primarily, eat more fresh vegetables and fruits, and reduce the burden on the liver to better facilitate recovery from the condition.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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Will a liver hemangioma show blood flow signals on an ultrasound?

Patients with hepatic hemangiomas exhibit blood flow during ultrasound examinations. Hepatic hemangiomas are common benign tumors of the liver that usually don't show noticeable symptoms when they are small and don't require special treatment; routine follow-up with color Doppler ultrasound is sufficient. However, if a hepatic hemangioma is large, it could potentially rupture and bleed, making the condition severe. This could even lead to hemorrhagic shock and death. Therefore, patients with large hepatic hemangiomas should undergo surgery as soon as possible. Surgical intervention is necessary to cure the condition, with the primary method being interventional surgery, which can achieve the treatment objectives.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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Why is it not recommended to perform surgery on hepatic hemangiomas?

Patients with hepatic hemangioma generally do not exhibit obvious symptoms, and most cases are discovered during color Doppler ultrasound examinations. Hence, surgical treatment is not required at this time. It is possible to regularly re-examine the color Doppler ultrasound dynamics and monitor any changes in volume. However, for large hepatic hemangiomas, complications such as rupture, bleeding, and even life-threatening hemorrhagic shock may occur, leading to death. Therefore, early surgical treatment is advised for such cases. The primary method is minimally invasive surgery achieved through interventional procedures. Post-surgery, regular follow-up with color Doppler ultrasound is also necessary to dynamically observe any changes in the condition.

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Written by Liu Wu Cai
Hepatobiliary Surgery
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Can a six-centimeter liver hemangioma be treated with minimally invasive surgery?

For patients with liver hemangiomas, if the size reaches six centimeters, it is relatively large at this point and there may be a risk of rupture and bleeding. Thus, it is advisable to opt for early surgical intervention. The primary method for this would be minimally invasive surgery, which is achieved through vascular interventional surgery. Post-surgery, it is still necessary to have regular follow-up examinations with color Doppler ultrasound to monitor changes in the condition. Generally, for patients with liver hemangiomas of a relatively small size, they usually do not experience significant discomfort and do not require special treatment. Regular follow-up with color Doppler ultrasound to observe any changes in size is sufficient. Of course, it is advisable to avoid spicy and irritating foods in the diet to reduce inflammatory stimulation and lessen the burden on the liver, thereby helping to control the condition.