title: Spontaneous rupture of giant liver hemangioma: case report.
abstract: BACKGROUND
  Hemangioma is the most frequent benign solid tumor of the liver. It is well known that a giant liver hemangioma carries the risk of spontaneous rupture, followed by hemoperitoneum and hemorrhagic shock with possible fatal outcome.
  
  
  METHODS
  This is a case report of the spontaneous rupture of a giant cavernous hemangioma of the liver in an 85-year old patient.The patient was presented with abdominal pain and hemorrhagic shock. Emergency ultrasonography and computed tomography of the abdomen showed a heterogeneous ruptured solid tumor of the right liver lobe, multiple cysts in the left lobe and massive hemoperitoneum. The patient was successfully managed by immediate exploratory laparotomy, surgical enucleation of the hemangioma under intermittent inflow vascular occlusion, temporary perihepatic packing and planned second look relaparotomy.
  
  
  CONCLUSIONS
  Immediate surgical procedure is indicated mandatory in unstable patients with a ruptured giant hemangioma of the liver. Surgical enucleation under intermittent inflow vascular occlusion and temporary perihepatic packing could be a life-saving procedure in those patients.
authors.affiliation: Clinic for Emergency Surgery, Clinical Center of Serbia, Belgrade, Serbia. krstinadoklestic@gmail.com
authors.forename: Krstina
authors.initials: K
authors.lastname: Doklestić
authors.forename: Branislav
authors.initials: B
authors.lastname: Stefanović
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Karamarkovik
authors.forename: Vesna
authors.initials: V
authors.lastname: Bumbasirević
authors.forename: Branislava
authors.initials: B
authors.lastname: Stefanović
authors.forename: Pavle
authors.initials: P
authors.lastname: Gregorić
authors.forename: Dejan
authors.initials: D
authors.lastname: Radenković
authors.forename: Djordje
authors.initials: D
authors.lastname: Bajec
mesh_terms: D000369:Aged, 80 and over; D006392:Hemangioma, Cavernous / Q000150:complications*; D006465:Hemoperitoneum / Q000209:etiology; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications*; D008297:Male; D012422:Rupture, Spontaneous; D012771:Shock, Hemorrhagic / Q000209:etiology