title: Hemoperitoneum from a spontaneous rupture of a giant hemangioma of the liver: report of a case.
abstract: Hemangioma is the most common benign tumor of the liver and it is often asymptomatic. Spontaneous or traumatic rupture, intratumoral bleeding, consumption coagulopathy, and rapid growth are mandatory surgical indications. We report a case of giant hemangioma of hepatic segments II and III, which presented as hemoperitoneum, and were treated successfully with preoperative transcatheter arterial embolization (TAE) and hepatic bisegmentectomy. A PubMed Medline search has identified up to now 32 cases of spontaneous rupture of hepatic hemangioma in adults (age >14 years) without a history of trauma, including the present case. Twenty-seven out of these were reviewed. Sixteen (84.2%) of 19 tumors of known size were giant hemangiomas (mean diameter 14.8 cm; range 6-25). Twenty-two (95.7%) patients underwent surgery. Thirteen patients (59.1%) had a resection, 5 (22.8%) were sutured, and 4 (18.1%) underwent tamponade. Three (23%) out of the 13 resected patients died. Four patients (30.8%) underwent TAE prior to elective hepatic resection without any operative mortality. Among the 5 sutured patients, 2 (40%) died as well as 3 (75%) out of 4 patients who underwent tamponade. The mortality rate of all surgery patients was 36.4% (8/22).
authors.affiliation: Department of Surgery Pietro Valdoni, Policlinico Umberto I, University of Rome La Sapienza, Viale del Policlinico 155, 00161 Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Corigliano
authors.forename: Paolo
authors.initials: P
authors.lastname: Mercantini
authors.forename: Pietro Maria
authors.initials: PM
authors.lastname: Amodio
authors.forename: Genoveffa
authors.initials: G
authors.lastname: Balducci
authors.forename: Salvatore
authors.initials: S
authors.lastname: Caterino
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ramacciato
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ziparo
mesh_terms: D000328:Adult; D005260:Female; D006391:Hemangioma / Q000150:complications*; D006465:Hemoperitoneum / Q000209:etiology*; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications*; D008875:Middle Aged; D012422:Rupture, Spontaneous