title: Blunt abdominal injury with rupture of giant hepatic cavernous hemangioma and laceration of the spleen.
abstract: A 41-year-old woman with blunt abdominal trauma due to a motor vehicle accident presented to our emergency department. The patient had a history of a giant hepatic cavernous hemangioma. Emergency exploratory laparotomy was performed for suspected intra-abdominal bleeding with abdominal compartment syndrome, and more than 4 liters of blood and blood clots were removed. An active bleeding laceration (5 cm) of a hepatic cavernous hemangioma was detected in segment III of the liver. The bleeding was controlled by sutures, Teflon patches and tamponade. The abdomen was closed temporarily using the vacuum-assisted method. Because of the presence of persistent fresh blood through abdominal drainage at a rate of >1 L/h, splenectomy was performed to control the bleeding again by sutures and Teflon patches. Finally, the abdomen was closed using a biologic mesh. The patient was discharged home 30 days after trauma. Bleeding of trauma-caused hepatic hemangioma is rare, but splenic injury due to blunt abdominal trauma is common. An in-depth investigation is necessary to avoid second intervention.
authors: Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, China. conroy0615@yahoo.com.tw.
authors: Lung-Yun
authors: LY
authors: Kang
authors: Fong-Dee
authors: FD
authors: Huang
authors: Yuan-Yuarn
authors: YY
authors: Liu
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D000063:Accidents, Traffic; D000328:Adult; D005260:Female; D006392:Hemangioma, Cavernous / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006489:Hemostatic Techniques; D006801:Humans; D022125:Lacerations / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D054843:Negative-Pressure Wound Therapy; D011237:Predictive Value of Tests; D012421:Rupture; D013154:Spleen / Q000293:injuries* / Q000601:surgery; D013156:Splenectomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery