Spontaneous rupture of a giant hepatic hemangioma. Sequential treatment with preoperative transcatheter arterial embolization and conservative hepatectomy.
Hemangioma is the most common benign tumor of the liver and it is often asymptomatic. Spontaneous rupture of liver hemangiomas is a rare but potentially lethal complication. Emergent hepatic resection has been the treatment of choice but carries high operative morbidity and mortality. Recently, preoperative transcatheter arterial embolization (TAE) has been used successfully for the management of bleeding ruptured liver tumors and non-operative treatment of symptomatic giant liver hemangiomas. We report a case of spontaneous rupture of a giant hepatic hemangioma that presented with thoracic and abdominal pain and shock due to hemoperitoneum. Once proper diagnosis was made the patient was successfully managed by TAE, followed by conservative hepatic resection.
Department of General and Oncologic Surgery, Sao Paulo Estate Employees Hospital, Sao Paulo, Brazil.
R M
RM
Lupinacci
D
D
Szejnfeld
J F M
JF
Farah
D004621:Embolization, Therapeutic / Q000379:methods*; D004630:Emergencies; D017707:Erythrocyte Transfusion; D005260:Female; D006391:Hemangioma / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006465:Hemoperitoneum / Q000209:etiology / Q000628:therapy; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D012422:Rupture, Spontaneous / Q000150:complications / Q000601:surgery; D014057:Tomography, X-Ray Computed