Traumatic Rupture of a Hepatic Hemangioma

간혈관종의 외상성 파열

  • Sung, Ji Eun (Department of Surgery, Ulsan University Hospital and University of Ulsan College of Medicine) ;
  • Park, Sang Jun (Department of Surgery, Ulsan University Hospital and University of Ulsan College of Medicine) ;
  • Nam, Chang Woo (Department of Surgery, Ulsan University Hospital and University of Ulsan College of Medicine) ;
  • Hwang, Jae Chol (Department of Radiology, Ulsan University Hospital and University of Ulsan College of Medicine) ;
  • Kim, Young Min (Department of Pathology, Ulsan University Hospital and University of Ulsan College of Medicine)
  • 성지은 (울산대학교병원 외과학교실) ;
  • 박상준 (울산대학교병원 외과학교실) ;
  • 남창우 (울산대학교병원 외과학교실) ;
  • 황재철 (울산대학교병원 영상의학과) ;
  • 김영민 (울산대학교병원 병리과)
  • Received : 2013.08.09
  • Accepted : 2013.09.09
  • Published : 2013.09.30

Abstract

A hepatic hemangioma is the most frequent benign liver tumor. Once rupture occurs, the bleeding can barely be controlled by using conservative management or endovascular treatment. We report a case of traumatic hepatic hemangioma rupture. A 60-year-old man was referred to our hospital under cardiopulmonary cerebral resuscitation (CPCR). CPCR was continued for 16 minutes after his admission to the emergency room (ER). Computed tomography (CT) showed fluid accumulation in the peritoneal cavity with active contrast extravasation in the left lateral segment of the liver. Percutaneous transarterial embolization and massive transfusion were carried out. Embolization did not stop the bleeding, we decided on an exploration and then resected the lateral segment of the liver to control the bleeding. The specimen showed a ruptured hemangioma in the liver segment.

Keywords

References

  1. Choi BY, Nguyen MH, The Diagnosis and Management of Benign Hepatic Tumors, J Clin Gastroenterol 2005; 39: 401-12. https://doi.org/10.1097/01.mcg.0000159226.63037.a2
  2. Buell JF, Tranchart H, Cannon R, Dagher I, Management of benign hepatic tumors, Surg Clin North Am. 2010; 90(4): 719-35. https://doi.org/10.1016/j.suc.2010.04.006
  3. Badger SA, Barclay R, Campbell P, Mole DJ, Diamond T Management of liver trauma, World J Surg. 2009; 33(12): 2522-37. https://doi.org/10.1007/s00268-009-0215-z
  4. Hotokezaka M, Kojima M, Nakamura K, Hidaka H, Nakano Y, Tsuneyoshi M,et al,. Traumatic rupture of hepatic hemangioma, J Clin Gastroenterol. 1996l; 23(1): 69-71. https://doi.org/10.1097/00004836-199607000-00020
  5. Gilon D, Slater PE, Benbassat J. Can decision analysis help in the management of giant hemangioma of the liver? J Clin Gastroenterol. 1991; 13(3): 255-8.
  6. Duxbury MS, Garden OJ. Giant haemangioma of the liver: observation or resection? Dig Surg. 2010; 27(1): 7-11. https://doi.org/10.1159/000268108
  7. Jr MA, Papaiordanou F, Goncalves JM, Chaib E., World J Hepatol. Spontaneous rupture of hepatic hemangiomas: A review of the literature , 2010; 2(12): 428-33. https://doi.org/10.4254/wjh.v2.i12.428
  8. Casillas VJ, Amendola MA, Gascue A, Pinnar N, Levi JU, Perez JM., Imaging of nontraumatic hemorrhagic hepatic lesions, Radiographics. 2000; 20(2): 367-78. https://doi.org/10.1148/radiographics.20.2.g00mc10367