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Signa vitae : journal for intesive care and emergency medicine, Vol. 6 No. 1, 2011.

Professional paper

A hematoma confined to the center of the abdomen

Mon-Ing Tsai ; Department of Emergency Medicine, Department of Radiology, Chang Gung Memorial Hospital, No.5, Fusing St., Gueishan Township, Taoyuan County, 333, Taiwan, ROC. College of Medicine, Chang Gung University, Tao Yuan, Taiwan4.
Chien-Cheng Chen ; Department of Emergency Medicine, Department of Radiology, Chang Gung Memorial Hospital, No.5, Fusing St., Gueishan Township, Taoyuan County, 333, Taiwan, ROC. College of Medicine, Chang Gung University, Tao Yuan, Taiwan4.
Chih-Huang Li ; Department of Emergency Medicine, Department of Radiology, Chang Gung Memorial Hospital, No.5, Fusing St., Gueishan Township, Taoyuan County, 333, Taiwan, ROC. College of Medicine, Chang Gung University, Tao Yuan, Taiwan4.
Te-Fa Chiu ; Department of Emergency Medicine, Department of Radiology, Chang Gung Memorial Hospital, No.5, Fusing St., Gueishan Township, Taoyuan County, 333, Taiwan, ROC. College of Medicine, Chang Gung University, Tao Yuan, Taiwan4.
Jih-Chang Chen ; Department of Emergency Medicine, Department of Radiology, Chang Gung Memorial Hospital, No.5, Fusing St., Gueishan Township, Taoyuan County, 333, Taiwan, ROC. College of Medicine, Chang Gung University, Tao Yuan, Taiwan4.
Cheng-Hsien Hsieh ; Department of Emergency Medicine, Department of Radiology, Chang Gung Memorial Hospital, No.5, Fusing St., Gueishan Township, Taoyuan County, 333, Taiwan, ROC. College of Medicine, Chang Gung University, Tao Yuan, Taiwan4.

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Abstract

Spontaneous rupture of a hepatocellular carcinoma is a rare and lethal complication in the emergency department. A caudate lobe hepatoma rupture is even rarer. It can be treated with vascular embolization, surgical intervention or supportive care. A 70-year-old woman with underlying hepatocellular carcinoma presented to our emergency department with severe abdominal pain encompassing the entire region for half a day. Abdominal computer tomography scans with and without contrast medium revealed a large hematoma confined to the lesser sac of the abdomen. It was initially diagnosed as a ruptured aneurysm. A ruptured caudate lobe hepatoma with acute hemorrhage into the lesser sac was diagnosed after reviewing and discussing the imaging findings with the radiologist. The patient was treated with supportive care without vascular embolization or surgical intervention because there was no imaging evidence of active contrast extravasation and the vital signs were within the normal range. After reviewing the literature, our case appears to be the second only case treated with supportive care and discharged without complications.

Keywords

hepatom; hepatocellular carcinoma; caudate; rupture; peritonitis

Hrčak ID:

67495

URI

https://hrcak.srce.hr/67495

Publication date:

1.4.2011.

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