title: Hemoperitoneum caused by spontaneous rupture of hepatocellular carcinoma.
abstract: We are reporting a male, 46 years old came to emergency unit with a chief complaint of abdominal tenderness since 1 day prior to admission. No history of abdominal trauma. He often felt abdominal discomfort for the last 5 years. Physical examination revealed decreased consciousness, shock, pale conjungtiva, distended abdomen, with tenderness of the whole abdomen on palpation, and no bowel movement. Laboratory examination found anemia, leucocytosis, normal amilase and lipase. FAST (focus assissted Sonography on trauma) found massive ascites. Patient underwent cito laparotomic exploration that found blood on abdominal cavity, nodular liver, and actively bleeding tumour of liver. During hospitalization, patient recovered and discharged. In the case of acute abdomen, spontaneous ruptured hepatocellular carcinoma (HCC) is one of differential diagnosis, considering high incidence of HCC in South East Asia, especially Indonesia. Confirming diagnosis of generalized peritonitis requires abdominal CT scan and ultrasonography, to rule out ruptured HCC.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
authors.forename: Nata P Hardjo
authors.initials: NP
authors.lastname: Lugito
authors.forename: Andree
authors.initials: A
authors.lastname: Kurniawan
authors.forename: Rizki
authors.initials: R
authors.lastname: Yaruntradhani
authors.forename: Andhika
authors.initials: A
authors.lastname: Rachman
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006465:Hemoperitoneum / Q000601:surgery*; D006801:Humans; D007214:Indonesia; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous / Q000601:surgery*