Hepatosellüler karsinomada spontan intraperitoneal hemorajik rüptür: Olgu sunumu

Murat Ulaş, İlter Özer, Volkan Öter, Erol Aksoy, Şükran Ziyşan Sakaoğulları, Erdal Birol Bostancı
2.415 875


İntraperitoneal hemorajic rupture is a complication of hepatocellular carcinoma that can be mortal. Surgical management and arterial embolisation are the main therapy choices in selected cases. We presented a case of hepatocellular carcinoma with spontaneous rupture and intra-abdominal hemorrhage. A 70 years old male was admitted to emergency department with abdominal pain and unstable hemodynamy. Patient was taken the operation room due to intra-abdominal bleeding. İntraoperatif diagnosis was rupture haemorrhagic solid liver mass and they performed depacking and hemostasis. Then they decided to transport patient to our hospital (tertiary hospital). We perform depacking, liver segment resection (4b) and cholecystectomy operation. The histopathological examination for the resected specimen yielded the final diagnosis of welldifferentiated hepatocellular carcinoma. As in this case if there is not enough medical and technical equipment for curative surgery than after the first surgical intervention has been done transporting the patient to a tertiary hospital for curative surgery can be saving life.


Hepatocellular carcinoma, spontaneous rupture, therapeutic

Full Text:


DOI: http://dx.doi.org/10.7197/cmj.v36i3.1008002469


Perz JF, Armstrong GL, Farrington LA. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol 2006; 45: 529-38.

Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: GLOBOCAN 2000. Int J Cancer 2001; 94: 153-6.

Llovet JM, Burroughs A, Bruix J. Hepatocellular carcinoma. Lancet 2003; 362: 1907Vergara V, Muratore A, Bouzari H. Spontaneous rupture of hepatocellular carcinoma: Surgical resection and long-term survival. Eur J Surg Oncol 2000; 26: 770Nouchi T, Nishimura M, Maeda M. Transcatheter arterial embolization of ruptured hepatocellular carcinoma associated with liver cirrhosis. Dig Dis Sci 1984; 29: 1137-41.

Hiroyuki Kirikoshi, Satoru Saito, Masato Yoneda. Outcomes and factors influencing survival in cirrhotic cases with spontaneous rupture of hepatocellular carcinoma: A multicenter study. BMC Gastroenterology 2009; 30: 29.

Zhu LX, Wang GS, Fan ST. Spontaneous rupture of hepatocellular carcinoma. Br J Surg 1996; 3: 602-7.

Zhu LX, Geng XP, Fan ST. Spontaneous rupture of hepatocellular carcinoma and vascular injury. Arch Surg 2001; 136: 682-7.

Vivarelli M, Cavallari A, Bellusci R. Ruptured hepatocellular carcinoma: An important cause of spontaneous haemoperitoneum in Italy. Eur J Surg 1995; 161: 881Pombo F, Arrojo L, Perez Fontan J. Hemoperitoneum secondary to spontaneous rupture of hepatocelluar carcinoma: CT diagnosis. Clin Radiol 1991; 43: 321-2. Polat KY, Akcay MN, Aydınlı B. Spontaneous rupture of hepatocelluler carcinoma: a case report and review of literature. Int J Clin Pract Suppl 2005; 103Tan FL, Tan YM, Chung AY. Factors affecting early mortality in spontaneous rupture of hepatocellular carsinoma. ANZ J Surg 2006, 76: 448-52.

Liu CL, Fan ST, Lo CM. Management of spontaneous rupture of hepatocellular carcinoma: Single-center experience. J Clin Oncol. 2001; 19: 3725-32.

Buczkowski AK, Kim PT, Ho SG. Multidisciplinary management of ruptured hepatocellular carcinoma. J Gastrointest Surg 2006; 10: 379-86.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.