title: Treatment of a giant haemangioma of the liver with Kasabach-Merritt syndrome by orthotopic liver transplant a case report.
abstract: We describe a case of giant cavernous haemangioma of the liver with disseminated intravascular coagulopathy (Kasabach-Merritt syndrome) which was cured by orthotopic liver transplant. A 47 year old man presented with bleeding and tender massive hepatomegaly after tooth extraction. Investigations showed disseminated intravascular coagulopathy and a giant hepatic haemangioma involving both lobes of the liver. Initial treatment failed to resolve the coagulopathy and liver resection was attempted. At laparotomy the tumour was unresectable and the only option for cure was to offer a liver transplantation. The orthotopic liver transplant was performed 20 days after initial laparotomy. Subsequently, all coagulation parameters returned to normal and the patient remains well after 12 months. Orthotopic liver transplant can be considered for giant hepatic haemangioma with Kasabach-Merritt syndrome when resection is necessary and a partial hepatectomy is not technically feasible.
authors.affiliation: Department of Surgery, Flinders Medical Centre, Adelaide, South Australia.
authors.forename: J H
authors.initials: JH
authors.lastname: Longeville
authors.forename: P
authors.initials: P
authors.lastname: de la Hall
authors.forename: P
authors.initials: P
authors.lastname: Dolan
authors.forename: A W
authors.initials: AW
authors.lastname: Holt
authors.forename: P E
authors.initials: PE
authors.lastname: Lillie
authors.forename: J A
authors.initials: JA
authors.lastname: Williams
authors.forename: R T
authors.initials: RT
authors.lastname: Padbury
mesh_terms: D004211:Disseminated Intravascular Coagulation / Q000150:complications*; D006392:Hemangioma, Cavernous / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D013577:Syndrome; D014057:Tomography, X-Ray Computed