Spontaneous rupture of hepatocellular carcinoma with haemoperitoneum: a rare condition in Western countries

Chedid, AD; Klein, PW; Tiburi, M.F.; Villwock, MM; Bassani, L; Chedid, MF

doi:10.1080/136518201753242262

Cited by 20 publications

(20 citation statements)

References 24 publications

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“…In hemoperitoneum occurring as a result of rupture of hepatocellular carcinoma, transcatheter arterial embolization has been previously described as a potential therapeutic option [1,2]. …”

Section: Discussionmentioning

confidence: 99%

Bleeding from ruptured hepatic metastases as a cause of syncope in an octogenarian: a case report

2010

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IntroductionAcute hemoperitoneum as a result of hemorrhage from liver metastases is an uncommon but serious condition. The use of appropriate imaging is important in the diagnosis and can have a profound impact on subsequent management. This case is important because the presentation was of recurrent syncopal episodes with an unusual underlying cause. This case highlights the need to consider this diagnosis in the differential in patients presenting with collapse in the acute setting.Case presentationWe present the case of an 85-year-old Caucasian man who was admitted following a collapse episode and was found to be persistently hypotensive despite aggressive resuscitation. An acute intra-peritoneal bleed originating from hepatic metastases from an unknown primary was identified promptly with computed tomography imaging and was subsequently managed conservatively.ConclusionsThis case aims to convey key teaching points: (A) the need to consider intra-abdominal hemorrhage in the differential diagnosis when assessing patients with collapse; and (B) the use of appropriate imaging such as computed tomography can facilitate a prompt diagnosis and appropriate management steps can then be taken accordingly.

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“…In hemoperitoneum occurring as a result of rupture of hepatocellular carcinoma, transcatheter arterial embolization has been previously described as a potential therapeutic option [1,2]. …”

Section: Discussionmentioning

confidence: 99%

Bleeding from ruptured hepatic metastases as a cause of syncope in an octogenarian: a case report

2010

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“…Spontaneous rupture with potentially fatal haemoperitoneum is a not infrequent complication with a frequency ranging from 2.9 to 26% (7). A high incidence is found in Asia and Africa, but it is less common in developed countries (3,7,8).…”

Section: Discussionmentioning

confidence: 99%

“…Rupture of HCC occurs in about 10–15% of patients whereas rupture is the mode of presentation for nearly 50% of patients with adenoma (5). Non‐tumorous conditions such as peliosis hepatis, polyarteritis nodosa, systemic lupus erythematosus (SLE) and the changes associate with pre‐eclampsia may also present with free intra‐abdominal bleeding (8). Peliosis is an infrequent entity characterised by multiple blood‐filled cavities mostly involving the liver.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous rupture of hepatocellular carcinoma: a case report and review of literature

Polat

Akçay

Aydınlı

et al. 2004

International Journal of Clinical Practice

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Hepatocellular carcinoma (HCC) has a tendency for fatal spontaneous rupture leading to massive haemorrhage. A 64-year-old man presented with sudden, severe epigastric pain for 6 h. Systolic blood pressure was 80/50 mmHg, and pulse rate was 100/min. The patient's history did not reveal any operation or disease up to date. Contrast enhancement-axial computed tomography (CT) scan showed a tumoral lesion with a necrotic centre measuring 6 · 5 cm within 6th segment of the liver and a fluid collection (haemoperitoneum) at the periphery of the liver. At exploratory laparotomy, the liver was found to be cirrhotic, and an actively bleeding tumour confirmed in 6th segment of the liver. The tumour was resected. Post-operative recovery was unremarkable, and the patient was discharged on the 14th post-operative day. Ruptured HCC should be included in the differential diagnosis of non-traumatic intra-abdominal haemorrhage.

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“…The rupture incidence in HCC is reduced by early diagnosis. 1 , 2 Spontaneous rupture has been reported in patients with HCC between 3% and 26% and the mortality rate due to ruptured HCC is between 32% and 66%. 3 The lack of initial diagnosis such as cirrhosis and HCC leads to difficulty in the diagnosis of ruptured HCC in emergency conditions.…”

Section: Introductionmentioning

confidence: 99%

“…Surgery, arterial embolization, and/or conservative therapy are the treatment options in ruptured HCC patients and are performed according to the status of the disease. 1 – 3 In this report, we present the clinical and CT findings of hemoperitoneum due to spontaneous HCC rupture in a 52-year-old patient first diagnosed in the emergency radiology department. Consent was obtained from the patient for publication of this article.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous rupture of multifocal hepatocellular carcinoma: case report

Özen¹,

Tosun²,

Akgül³

2015

IMCRJ

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Hemoperitoneum due to nontraumatic liver rupture is rare. The most common cause of nontraumatic rupture of the liver is hepatocellular carcinoma (HCC). The other causes of nontraumatic liver ruptures are peliosis hepatis, polyarteritis nodosa, systemic lupus erythematosus, preeclampsia, metastatic carcinoma, and other primary liver tumors. In this report, we present the computed tomography findings of spontaneous liver rupture in a 52-year-old male patient due to multifocal HCC, with the diagnosis proven by surgical specimen.

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Spontaneous rupture of hepatocellular carcinoma with haemoperitoneum: a rare condition in Western countries

Abstract: The prognosis for patients with haemoperitoneum is generally poor. Although this condition is relatively frequent in some regions of Asia and Africa, it has rarely been reported in Western countries.The present experience shows that emergency laparotomy can be life-saving.

Cited by 20 publications

References 24 publications

Bleeding from ruptured hepatic metastases as a cause of syncope in an octogenarian: a case report

Bleeding from ruptured hepatic metastases as a cause of syncope in an octogenarian: a case report

Spontaneous rupture of hepatocellular carcinoma: a case report and review of literature

Spontaneous rupture of multifocal hepatocellular carcinoma: case report

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