Professional Documents
Culture Documents
Name: Gong.
Sex: Female.
Age: 42 years.
Occupation: A self employed transportation person.
Chief Complaint: Recurrence of hepatic hemangiomatosis for 3
months after lobectomy of liver.
History of Present Illness: Three years ago, the patient found
that there were some size-varied hemangiomas in her liver
through physical examination. At that time, it wasn't
accompanied by other symptoms. After being treated in local
hospitals for almost half a year, it was affirmed as a rule that
no drug could cure this illness, only by operation, could it be
healed. Then she had to accept an operation named as
"lobectomy of liver" 2 years ago in a hospital. After the
operation, reexaminations of ultrasonogram B showed that
most of the hepatic hemangiomas had been resected, only 3
little hepatic hemangiomas scattered in the right lobe.
Additionally, there was not uncomfortable sensation any more.
Then she considered the illness had been healed
completely. 3 months ago, she slowly got a distending-pain in
the right inferocostal region, accompanied with chest
oppression, shortness of breath, fatigue and lassitude. Then
she went to hospitals again and it was found that there were 9
size-varied hepatic hemangiomas in the right lobe. It was
diagnosed as Recurrence of Hepatic Hemangiomatosis. "After
consultation of physician and surgeon, it was still considered
that no drugs could cure this illness. Furthermore, the patient
herself lost any faith in operation. Then she came here for
treatment on January 8,1999 through somebody.
Physical Examination: The patient was conscious with a fresh
red complexion. She was fat. The pulse was thready and
uneven, the tongue was dark red with a thin layer of white fur.
HR was 88beats/min. No murmur could be heard. The
respiratory sounds were harsh, no rale could be heard. The
abdomen was soft and flat. There was slight tenderness in the
right inferocostal region. The liver and the spleen could not be
palpated in the both inferocostal regions. There was not other
abnormal sign.
Examination of Multicoloured Ultrasonogram: It showed there
were 9 masses of high echo in the right lobe of liver, size of the
biggest one was 2.2cm2.lcm, diameters of the others were all
from 0.5cm to 1.5cm. All these signs indicated it was hepatic
hemangiomatosis.
Diagnosis: Hepatic Hemangiomatosis.
Differentiation: This disease, in TCM, belongs to the category of
"GanZhengJia"(hepatic mass). It's syndrome of qi stagnation
and blood stasis in liver. The liver's attribute is Yin wood
according to the Five element theory of TCM, it controls the
dispersive effect of the body. Under normal conditions, the liver
promotes the functional activities of the monarch fire and
restrains the functionless activities of the dampness-soil.
However, there had been stagnation of liver qi and stasis of
liver blood. So that the liver couldn't promote the functional
activities of the heart and there was deficency of heart-qi, then
the patient got the chest oppression and shortness of breath,