2021, Number 3
Hemoperitoneum secondary to rupture of hepatocellular carcinoma
Language: Spanish
References: 11
Page:
PDF size: 376.45 Kb.
ABSTRACT
Introduction: Hepatocellular carcinoma is a hypervascular tumor made up of abnormal blood vessels. It is the most frequent form of primary liver cancer. About 90 % of these tumors develop over a previous liver disease. An increase in vascular load due to portal hypertension leads to bleeding.Objective: To present a patient who underwent emergency exploratory laparotomy due to large hemoperitoneum secondary to an intratumoral rupture of a cirrhotic liver.
Clinical case: A 66-year-old male patient with a pathological history of type 2 diabetes mellitus, benign prostatic hyperplasia, chronic alcoholism and liver cirrhosis. He came to emergency due to diffuse abdominal pain, as well as signs of acute hypovolemia. An emergency laparotomy was performed, confirming a large hemoperitoneum secondary to an intratumoral rupture. Blood content aspiration, electrocoagulation and compression by packing were performed, managing to control bleeding. He had a torpid evolution, dying 24 hours after the laparotomy.
Conclusions: Hemoperitoneum secondary to rupture of a hepatocellular carcinoma is a rare, but fatal complication; therefore, its study is necessary to achieve a timely diagnosis and treatment.
REFERENCES
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Ayala-Haro N, Sandoval-Illescas MC, Martínez-Navarro LJ, Cruz-Fabián S. Hemoperitoneo en pacientes con cirrosis hepática. Evidencia Médica e Investigación en Salud. 2015 [acceso: 22/04/2020];8(3):128-131. Disponible en: Disponible en: https://biblat.unam.mx/hevila/Evidenciamedicaeinvestigacionensalud/2015/vol8/no3/5.pdf
Tanaka S, Kaibori M, Ueno M, Wada H, Hirokawa F, Nakai T, et al. Surgical outcomes for the ruptured hepatocellular carcinoma: multicenter analysis with a case-controlled study. J Gastrointest Surg. 2016 [acceso: 15/02/2020];20:2021-34. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/27718151/
Schwarz L, Bubenheim M, Zemour J, Herrero A, Muscari F, Ayav A. Bleeding recurrence and mortality following interventional management of spontaneous HCC rupture: Results of a multicenter European study. World J Surg. 2018 [acceso: 15/02/2020];42:225-232. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/28799103/