[Spontaneous hemoperitoneum: diagnosis, prognosis and possible therapeutics].
We report the case of a 58-year-old diabetic man admitted to the hospital in a comatose state due to medicamentous hypoglycemia in a context of hypovolemic acute renal failure. Hypovolemia was due to hemoperitoneum in a alcoholic patient with cirrhotic hepatic failure. CT-scan and arterial angiographies revealed a voluminous isolated hepatic mass with active bleeding suggesting the diagnosis of spontaneous bleeding from a hepatocellular carcinoma. The hemorrhage resolved after selective arterial embolization, but the patient died two weeks later from an infectious cause. The differential diagnosis of a spontaneous hemoperitoneum and possibilities of treatment in the case of ruptured hepatocellular carcinoma are discussed.
Jayet
P Y
PY
Service de Médecine Interne, CHUV, Lausanne.
Frochaux
V
V
Qanadli
S
S
Lamy
O
O
D006528:Carcinoma, Hepatocellular / Q000150:complications*; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic; D006465:Hemoperitoneum / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications*; D008297:Male; D008875:Middle Aged; D019152:Paracentesis; D011379:Prognosis; D011860:Radiography, Abdominal; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed