Hepatic vascular murmur

Introduction Some giant liver cancers can compress or distort the common hepatic artery or celiac artery, causing a nuzzle-like vascular murmur in the liver area, which is a special sign of liver cancer. The incidence of vascular murmurs is lower in domestic reports, while foreign reports are higher.

Cause

Causes of vascular murmur in the liver area: mainly caused by liver cancer.

an examination

Related inspection

Liver, gallbladder, spleen CT examination A fetal globulin test amino acid clearance rate determination magnetic resonance angiography angiography

1. Auscultation: There is a hairy vascular murmur in the liver area.

2. Magnetic resonance angiography.

3. Ultrasound diagnosis of liver disease.

4, liver, gallbladder, spleen CT examination.

5, a kind of fetal globulin test.

Differential diagnosis

Differential diagnosis of vascular murmur in the liver:

1, left upper abdomen vascular murmur: the patient takes a supine position, with a stethoscope in the left upper abdomen for auscultation, can smell a short systolic murmur, that is, this murmur is more limited, generally not far. This murmur is caused by the compression of the celiac artery by the pancreatic body and tail cancer, especially the compression of the splenic artery. It is considered to be an important characteristic feature of the early stage of pancreatic body and tail cancer. It can also be seen in the spleen aneurysm, which needs to be performed by angiography. Identification.

2, liver area arterial murmur: in the upper abdomen or right side of the swollen liver parts and systolic hairy murmur, the conduction range is related to the extent of liver enlargement, the greater the liver's transmission range, sometimes in the umbilical cord, spleen The area and the right back can be heard. The farther away from the liver, the weaker the noise. This kind of noise has certain diagnostic significance for primary liver cancer, but it can also be seen in other liver diseases. The production of this noise is caused by liver cancer pressing the hepatic artery or the abdominal aorta, and may also be caused by the blood vessel of the cancer itself or the disease of the hepatic artery itself.

3, hepatic vein murmur: can be seen in the following situations:

1 gram of abalone syndrome: Intrinsic cirrhosis or other causes of portal hypertension, promote the re-opening of the umbilical vein and umbilical vein after birth, and form a collateral circulation with the chest and abdominal wall vein. When blood flow is injected into these tortuous veins from the higher pressure portal vein, turbulence is formed and noise is generated. It can smell continuous in the xiphoid and around the umbilicus, similar to the venous sound of bees flapping and low pitch. After deep inhalation and compression of the spleen, the noise is enhanced, and the auscultation in the lying position or standing position is more obvious than the sitting position. When the stethoscope is gradually pressurized, the noise gradually weakens to disappear, and the tremor can be touched at the loudest part of the noise;

2 hepatic cavernous hemangioma: the vein camping sound can be heard on the mass, and the noise of the hand can be obviously weakened or disappeared.

Three-door vena cava anastomosis can also be heard in the hepatic vein murmur.

4, abdominal aorta and its branches are compressed

1 Pancreatic cancer: The splenic artery is directly distributed on the pancreatic body. When the pancreatic body and tail cancer press this branch, a short systolic murmur may appear in the left upper abdomen.

2 Abdominal aorta compression syndrome: caused by compression of the abdominal aorta by the inguinal arcuate ligament or celiac ganglion lesions, the upper abdomen can smell systolic murmur, and accompanied by intermittent upper abdominal pain unrelated to diet.

5. Noise from the abdominal aorta and its branches

1 Abdominal aortic aneurysm: In the upper abdomen, a pulsatile mass such as a fist in a child's fist can be touched, and a squeaky noise can be heard on the mass;

2 splenic aneurysm: the left upper abdomen can be heard and systolic murmur;

3 hepatic aneurysm: tremors and systolic murmurs can be touched in the gallbladder area.

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