Manejo terapéutico de la hemorragia espontánea hepática debido a una hiperplasia nodular focal

Cintas, Teófilo Cubo; Padilla, David; Campos, Pedro Villarejo; Useros, Antonio López; Campillo, Carmen Manzanares; Martín, Francisco Javier Escalada San; Zarca, Miguel A.

doi:10.1157/13108805

Cited by 5 publications

(1 citation statement)

References 21 publications

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“…Liver resection has been recommended for symptomatic or enlarging HA because of the associated risk of intraperitoneal or intrahepatic hemorrhage or even the development of hepatocellular carcinoma. Surgery eventually should be performed in any case of HA, provided it can be done without significant morbidity or mortality 3,7–10…”

Section: Introductionmentioning

confidence: 99%

Surgical Management of Spontaneous Ruptured Hepatocellular Adenoma

Ribeiro

Chaib

Saad

et al. 2009

Clinics

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AIMSSpontaneous ruptured hepatocellular adenoma (SRHA) is a rare life-threatening condition that may require surgical treatment to control hemorrhaging and also stabilize the patient. We report a series of emergency surgeries performed at our institution for this condition.METHODSWe reviewed medical records and radiology files of 28 patients (from 1989 to 2006) with a proven diagnosis of hepatocellular adenoma (HA). Three (10.7%) of 28 patients had spontaneous ruptured hepatocellular adenoma, two of which were associated with intrahepatic hemorrhage while one had intraperitoneal bleeding. Two patients were female and one was male. Both female patients had a background history of oral contraceptive use. Sudden abdominal pain associated with hemodynamic instability occurred in all patients who suffered from spontaneous ruptured hepatocellular adenoma. The mean age was 41.6 years old. The preoperative assessment included liver function tests, ultrasonography and computed tomography.RESULTSThe surgical approaches were as follows: right hemihepatectomy for controlling intraperitoneal bleeding, and right extended hepatectomy and non-anatomic resection of the liver for intrahepatic hemorrhage. There were no deaths, and the postoperative complications were bile leakage and wound infection (re-operation), as well as intraperitoneal abscess (re-operation) and pleural effusion.CONCLUSIONSpontaneous ruptured hepatocellular adenoma may be treated by surgery for controlling hemorrhages and stabilizing the patient, and the decision to operate depends upon both the patient’s condition and the expertise of the surgical team.

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Section: Introductionmentioning

confidence: 99%

Surgical Management of Spontaneous Ruptured Hepatocellular Adenoma

Ribeiro

Chaib

Saad

et al. 2009

Clinics

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CT and MRI imaging at the acute phase of inaugural non-traumatic hepatic haemorrhages

Boulouis

Marmin

LeMaire

et al. 2013

Diagnostic and Interventional Imaging

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It is important in spontaneous liver haemorrhage to consider the high probability of hepatocarcinoma or potentially malignant lesions even when the patient has no known hepatic disorders, and especially in young patients. The results of this study show that imaging is a key issue at the acute phase of inaugural non-traumatic hepatic haemorrhages and requires a simple but complete triphasic injected protocol.

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