title: Rupture of a hepatic adenoma in a young woman after an abdominal trauma: a case report.
abstract: Unlike hepatic haemorrhage following blunt abdominal trauma, spontaneous abdomen bleeding is rare, even in the presence of a hepatocellular adenoma (HA) or carcinoma. However, the diagnosis of a tumour underlying a haematoma after liver trauma is unusual, especially when it occurs more after two years after the accident. Here, we report a case of a ruptured HA due to blunt abdominal trauma. A 36-year-old woman was admitted to our hospital with sudden onset of upper abdominal pain. Her medical history revealed a blunt abdominal trauma two years prior. Initial abdominal computed tomography scan revealed a large haematoma measuring more than 16 cm in diameter in the right lobe of the liver. Magnetic resonance imaging showed haemorrhagic areas and some regions with hepatocyte hyperplasia, suggesting HA. The patient underwent right hepatic lobectomy, and a histopathological examination confirmed a diagnosis of HA. In conclusion, it is important to consider that abdominal trauma may hide old, asymptomatic and not previously detected injuries, as in the case reported.
authors.affiliation: Department of Surgery, Federal University of Rio De Janeiro State-UNIRIO, Rio de Janeiro, RJ 20270-004, Brazil. ricardo.cotta@me.com
authors.forename: Ricardo Lemos
authors.initials: RL
authors.lastname: Cotta-Pereira
authors.forename: Luana Ferreira
authors.initials: LF
authors.lastname: Valente
authors.forename: Daniela Goncalves
authors.initials: DG
authors.lastname: De Paula
authors.forename: Antônio Luís
authors.initials: AL
authors.lastname: Eiras-Araújo
authors.forename: Antônio Carlos
authors.initials: AC
authors.lastname: Iglesias
mesh_terms: D000007:Abdominal Injuries / Q000150:complications / Q000601:surgery*; D018248:Adenoma, Liver Cell / Q000150:complications / Q000601:surgery*; D000328:Adult; D005260:Female; D006406:Hematoma / Q000150:complications / Q000601:surgery; D006465:Hemoperitoneum / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D011860:Radiography, Abdominal; D012421:Rupture / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000601:surgery*
keywords: Computed tomography; Hemoperitoneum; Hepatic adenoma; Trauma; Treatment