Abstract
Spontaneous rupture of hepatocellular carcinoma dose not rarely occur in Japan.
However, we often have much difficulties in the diagnosis and treatment and its prognosis is generally poor as yet. We report a case of spontaneously ruptured hepatocellular carcinoma (HCC) in which surgical treatmen successfully saved the life.
A 56-year-old male was admitted with hypochondralgia and faintness.
Ultrasonography, Computed tomography, and abdominal puncture revealed abdominal bleeding from spontaneously ruptured HCC. Emergency angiography showed a tumor stein in the left robe of the liver and tumor thrombus was suggested in the left portal branch by portography.
The bleeding was successfully stopped by means of selective transarterial embolization (TAE) of the left hepatic artery. Subsequently left hepatic resection was performed safely after disappearance of ascites under good liver condition confirmed by liver function tests. Resected specimen revealed that the main tumor located in the segment IV sized about φ 4cm and left portal branch was filled with tumor thrombus.
Successful treatments of spontaneously ruptured HCC are considered to be achieved by early and optimal diagnosis, cessation of bleeding by TAE, and operation under good conditions.
