- Santa Casa de Misericórdia, Serviço de Cirurgia Hepatobiliopancreática e Transplante Hepático - Porto Alegre - RS - Brasil.
Rev Col Bras Cir. 2023 Jul 10;50:e20233549. doi: 10.1590/0100-6991e-20233549-en. eCollection 2023.
hepatocellular adenoma - AHC - is a rare benign neoplasm of the liver more prevalent in women at reproductive age and its main complication is hemorrhage. In the literature, case series addressing this complication are limited.
between 2010 and 2022, 12 cases of bleeding AHC were attended in a high-complexity university hospital in southern Brazil, whose medical records were retrospectively evaluated.
all patients were female, with a mean age of 32 years and a BMI of 33kg/m2. The use of oral contraceptives was identified in half of the sample and also half of the patients had a single lesion. The mean diameter of the largest lesion was 9.60cm and the largest lesion was responsible for bleeding in all cases. The presence of hemoperitoneum was documented in 33% of the patients and their age was significantly higher than the patients who did not have hemoperitoneum - 38 vs 30 years, respectively. Surgical resection of the bleeding lesion was performed in 50% of the patients and the median number of days between bleeding and resection was 27 days. In only one case, embolization was used. The relation between ingrowth of the lesions and the time, in months, was not obtained in this study.
it is concluded that the bleeding AHC of the present series shows epidemiological agreement with the literature and may suggest that older patients trend to have hemoperitoneum more frequently, a fact that should be investigated in further studies.
肝细胞腺瘤（AHC）是一种罕见的肝脏良性肿瘤，多见于育龄期妇女，其主要并发症是出血。在文献中，针对这种并发症的病例系列研究有限。
2010 年至 2022 年，在巴西南部一家高复杂度的大学医院共收治了 12 例出血性 AHC 患者，对其病历进行了回顾性评估。
所有患者均为女性，平均年龄 32 岁，BMI 为 33kg/m2。有一半的患者使用了口服避孕药，有一半的患者只有一个病灶。最大病灶的平均直径为 9.60cm，所有病例均由最大病灶引起出血。有 33%的患者存在血腹，且其年龄明显高于无血腹的患者（分别为 38 岁和 30 岁）。有 50%的出血性病变患者接受了手术切除，出血至切除的中位时间为 27 天。仅 1 例患者采用了栓塞治疗。本研究未获得病变生长与时间（以月为单位）之间的关系。
本研究系列中的出血性 AHC 与文献中的流行病学特征一致，可能表明年龄较大的患者更常发生血腹，这一事实有待进一步研究。
