title: Spontaneous rupture of hepatocellular carcinoma with haemoperitoneum: a rare condition in Western countries.
abstract: BACKGROUND
  Haemoperitoneum secondary to non-traumatic liver rupture is a rare but potentially fatal condition. It may result from several neoplastic and non-neoplastic diseases such as primary benign or malignant tumours, peliosis hepatis, polyarteritis nodosa, systemic lupus erythematosus, pre-eclampsia and metastatic carcinoma.
  
  
  METHODS
  Three cases of spontaneous haemoperitoneum caused by rupture of hepatocellular carcinoma are described. All three patients (two men, one woman) had cirrhotic livers, and all were submitted to an urgent operation.One patient re-bled on a second occasion. Emergency operation was undertaken four times in three patients and was successful on all but one occasion.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Surgery Service, Hospital Ernesto Dornelles, Porto Alegre, Brazil.
authors.forename: A D
authors.initials: AD
authors.lastname: Chedid
authors.forename: P W
authors.initials: PW
authors.lastname: Klein
authors.forename: M F
authors.initials: MF
authors.lastname: Tiburi
authors.forename: M M
authors.initials: MM
authors.lastname: Villwock
authors.forename: L E
authors.initials: LE
authors.lastname: Bassani
authors.forename: M F
authors.initials: MF
authors.lastname: Chedid