title: Rupture of hepatic hemangioma with hemoperitoneum due to spontaneous gallbladder perforation: A unique case report.
abstract: BACKGROUND
  Hemangiomas are common benign tumors of the liver. Spontaneous rupture is a rare complication, occurring most commonly in giant hemangiomas. Rupture of a hemangioma with hemoperitoneum is a serious development and can be fatal if not managed promptly.The present study reports the unique case of a man who experienced rupture and hemorrhage of a hepatic hemangioma (HH) due to perforation of the gallbladder fundus. After en block resection of the hemangioma and gallbladder using the Pringle maneuver, the patient made an uneventful recovery without complications.To our knowledge, spontaneous rupture of HH secondary to gallbladder perforation has not been reported in the literature. This case highlights a unique, rare cause of ruptured HH and the need to consider appropriate treatment for some hemangiomas to avoid this potentially fatal complication.
  
  
  CONCLUSIONS
  The current case may provide additional support for treatment of HH due to the potential for spontaneous rupture. For patients with ruptured HH, enucleation with the Pringle maneuver is recommended.
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou Department of Hepatobiliary and Pancreatic Surgery, Shengzhou Branch of The First Affiliated Hospital, College of Medicine, Zhejiang University, Shengzhou, Zhejiang, P.R. China.
authors.forename: Qing-Hong
authors.initials: QH
authors.lastname: Ke
authors.forename: Chun-Jun
authors.initials: CJ
authors.lastname: Zhang
authors.forename: Hai-Feng
authors.initials: HF
authors.lastname: Huang
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D000328:Adult; D003937:Diagnosis, Differential; D005704:Gallbladder / Q000000981:diagnostic imaging / Q000601:surgery; D005705:Gallbladder Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006391:Hemangioma / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006465:Hemoperitoneum / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D012422:Rupture, Spontaneous / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D000072663:Spontaneous Perforation