Polat K Y, Akçay M N, Aydinli B, Erdogan F, Kantarci M, Oztürk G, Peker K
Department of General Surgery, Atatürk University Medical Faculty, Erzurum, Turkey.
Int J Clin Pract Suppl. 2005 Apr(147):103-5. doi: 10.1111/j.1742-1241.2004.00257.x.
Hepatocellular carcinoma (HCC) has a tendency for fatal spontaneous rupture leading to massive haemorrhage. A 64-year-old man presented with sudden, severe epigastric pain for 6 h. Systolic blood pressure was 80/50 mmHg, and pulse rate was 100/min. The patient's history did not reveal any operation or disease up to date. Contrast enhancement-axial computed tomography (CT) scan showed a tumoral lesion with a necrotic centre measuring 6 x 5 cm within 6th segment of the liver and a fluid collection (haemoperitoneum) at the periphery of the liver. At exploratory laparotomy, the liver was found to be cirrhotic, and an actively bleeding tumour confirmed in 6th segment of the liver. The tumour was resected. Post-operative recovery was unremarkable, and the patient was discharged on the 14th post-operative day. Ruptured HCC should be included in the differential diagnosis of non-traumatic intra-abdominal haemorrhage.
肝细胞癌（HCC）有发生致命性自发性破裂导致大量出血的倾向。一名64岁男性因突发剧烈上腹部疼痛6小时前来就诊。收缩压为80/50 mmHg，脉搏率为100次/分钟。患者既往史显示截至目前无任何手术或疾病史。增强轴向计算机断层扫描（CT）显示肝脏第6段有一个坏死中心直径为6×5 cm的肿瘤性病变，肝脏周边有液体积聚（血腹）。在剖腹探查术中，发现肝脏为肝硬化，肝脏第6段有一个活动性出血的肿瘤。肿瘤被切除。术后恢复顺利，患者于术后第14天出院。破裂的HCC应列入非创伤性腹腔内出血的鉴别诊断。
