Jabi Rachid, Sergi Badr, Soufi Mehdi, El Arabi Soumia, Miry Achraf, El Harroudi Tijani, Bouziane Mohamed
Department of General Surgery, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Oujda, Morocco.
Department of General Surgery, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Oujda, Morocco.
Int J Surg Case Rep. 2020;66:390-393. doi: 10.1016/j.ijscr.2019.12.038. Epub 2020 Jan 11.
Acute hemoperitoneum with a spontaneously ruptured hepatocellular carcinoma (HCC) is a rare type of internal bleeding that requires a multidisciplinary management approach.
In this case report, we describe a fortuitously ruptured peripheral and discovered HCC in an 81-years-old woman treated effectively using hepatectomy.
The use of the computed tomography (CT) angiography to diagnose the stability of the patient's condition allows both arterial embolization in case of active bleeding and the evaluation of the underlying hepatopathy. The place of surgery is particularly upon after both the failure of arterial embolization and while facing a severe hemodynamic instability. The surgical strategy varies between perihepatic tamponnade and a surgical resection in one or more stages. The prognosis of a ruptured HCC depends mainly on the underlying liver's function.
Multidisciplinary management of spontaneously ruptured HCC results in the same survival outcome as non-ruptured HCC at the same stage of hepatopathy.
急性腹腔积血合并肝细胞癌（HCC）自发破裂是一种罕见的内出血类型，需要多学科管理方法。
在本病例报告中，我们描述了一名81岁女性偶然发生的外周型HCC破裂，通过肝切除术得到有效治疗。
使用计算机断层扫描（CT）血管造影来诊断患者病情的稳定性，在有活动性出血时可进行动脉栓塞，并评估潜在的肝病情况。手术时机尤其在于动脉栓塞失败且面临严重血流动力学不稳定之时。手术策略在肝周填塞和一期或多期手术切除之间有所不同。破裂型HCC的预后主要取决于潜在肝脏的功能。
自发性破裂型HCC的多学科管理在肝病相同阶段可产生与未破裂型HCC相同的生存结果。
