title: Severe Anemia with Hemoperitoneum as a First Presentation for Multinodular Hepatocellular Carcinoma: A Rare Event in Western Countries.
abstract: Hemoperitoneum due to spontaneous rupture of hepatocellular carcinoma is a life-threatening and rare condition in western countries with an incidence of less than 3% because of early detection of cirrhosis and neoplasm. Here, we describe a case of a 66-year-old male patient with altered mental status with hemorrhagic shock. Computed tomography scan of abdomen revealed hemoperitoneum and mass in liver. Patient underwent resection of liver tumor and biopsy revealed multinodular hepatocellular carcinoma. A high degree of suspicion is required where severe anemia and hemoperitoneum can be a first presentation for hepatocellular carcinoma especially in patients with chronic hepatitis C infection. Early diagnosis is crucial since mortality rates remain high for untreated cases.
authors.affiliation: Department of Internal Medicine, Interfaith Medical Center, Brooklyn, NY, USA.
authors.forename: Thein
authors.identifier: 0000-0002-2905-6935
authors.initials: T
authors.lastname: Swe
authors.affiliation: Department of Internal Medicine, Interfaith Medical Center, Brooklyn, NY, USA.
authors.forename: Akari Thein
authors.initials: AT
authors.lastname: Naing
authors.affiliation: Department of Pathology, Interfaith Medical Center, Brooklyn, NY, USA.
authors.forename: Aama
authors.initials: A
authors.lastname: Baqui
authors.affiliation: Division of Oncology, Interfaith Medical Center, Brooklyn, NY, USA.
authors.forename: Ratesh
authors.initials: R
authors.lastname: Khillan