@article{article_312274, title={An Unusual Hemorrhagic Shock Caused by Spontaneous Rupture of Hepatocellular Carcinoma: A Case Report}, journal={Sakarya Tıp Dergisi}, volume={7}, pages={235–239}, year={2018}, DOI={10.31832/smj.312274}, author={Aziret, Mehmet and Ercan, Metin and Karaman, Kerem and Fırat, Necattin and Bostancı, Erdal Birol and Akoğlu, Musa}, keywords={Hemorajik şok; Hepatosellüler Karsinom (HCC); HCC rüptürü; Cerrahi tedavi}, abstract={<p class="MsoNormal" style="margin-bottom:.0001pt;text-align:justify;line-height:200%;"> <b> <span lang="en-us" style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;" xml:lang="en-us">Introduction: </span> </b> <span lang="en-us" style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;" xml:lang="en-us">Spontaneous rupture of hepatocellular carcinoma (HCC)
is a rare but fatal complication that can be occurred during follow up in
advanced stages of chronic liver failure. </span> </p> <p> </p> <p class="MsoNormal" style="margin-bottom:.0001pt;text-align:justify;line-height:200%;"> <b> <span lang="en-us" style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;" xml:lang="en-us">Case Report: </span> </b> <span lang="en-us" style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;" xml:lang="en-us">A 66-year-old male was admitted with tachycardia,
fade and abdominal distention </span> <span lang="en-us" style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;" xml:lang="en-us">
to the emergency clinic. The patient’s hemoglobin
level was 5 mg/dl and the hematocrit value was 19 %.Abdominal contrast-enhanced
computed tomography (CT) detected an extensive hematoma in the perihepatic area
with a laceration of 37.7x35 mm in the dome of the liver extending from segment
V to segment VIII. An emergent explorative laparotomy was performed in
hemorrhagic shock status. The tumor mass was resected with negative surgical
margins. Patient’s postoperative course was uneventful. </span> </p> <p> </p> <p class="MsoNormal" style="margin-bottom:.0001pt;text-align:justify;line-height:200%;"> <b> <span lang="en-us" style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;" xml:lang="en-us">Discussion: </span> </b> <span lang="en-us" style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;" xml:lang="en-us">Spontaneous HCC rupture is a catastrophic situation
which generally occurs suddenly and leads to coagulopathy, hemodynamic
instability and liver failure. These patients have usually sudden abdominal
pain, dizziness, confusion, fainting, tachycardia, and are often referred to
emergency clinic with hemodynamic instability or in hemorrhagic shock status.
Fall in hemotocrit levels is remarkable. Ultrasonography (USG) and CT is useful
in detecting the ruptured liver mass, intraperitoneal fluid or hematoma.
Resection of the ruptured tumor -if possible- should be considered.
Transarterial chemoembolization (TACE) and Transarterial chemoembolization (TACE)
are another alternative treatment options in selected cases where surgery is
not suitable. </span> </p> <p> </p> <p> </p> <p class="MsoNormal" style="margin-bottom:.0001pt;text-align:justify;line-height:200%;"> <b> <span lang="en-us" style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;" xml:lang="en-us">Conclusion: </span> </b> <span lang="en-us" style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;" xml:lang="en-us">Spontaneous HCC rupture is a serious life-threatening complication.
If possible, resection of the ruptured tumor mass in emergency situations is
not only lifesaving but also the treatment of choice of the primary disease. </span> </p> <p> </p>}, number={4}, publisher={Sakarya Üniversitesi}