Öz
Spontaneous rupture is a frequently mortal complication of the hepatocellular carcinoma. Although surgical management and arterial embolisation are the main therapy choices in selected cases, some cases can survive with conservative medical therapy alone. We presented a case of non mortal hepatocellular carcinoma rupture. A 67 years old male with alcoholic liver cirrhosis and hepatocellular carcinoma was admitted to emergency department with abdominal pain and hemodynamic shock. The possibility of the spontaneous rupture of hepatocellular carcinoma was thought because of the presence of the hemodynamic schock which occured after a period of a severe abdominal pain. This diagnosis became definite as the ascites fluid was hemorragic and findings of abdominal computerised tomography scan were supporting the diagnosis. He had conservative medical treatment at the intensive care unit, hemodynamic shock resolved in a few hours and finally he was discharged from hospital 12 days later from the admission
Anahtar Kelimeler
Kaynakça
- Llovet JM, Burroughs A, Bruix J. Hepatocellular carcinoma. Lancet. 2003; 362(9399):1907-1917.
- Vergara V, Muratore A, Bouzari H et al. Spontaneous rupture of hepatocellular carcinoma: surgical resection and long-term survival. Eur J Surg Oncol. 2000; 26(8):770-772.
- Nouchi T, Nishimura M, Maeda M et al. Transcatheter arterial embolization of ruptured hepatocellular carcinoma associated with liver cirrhosis. Dig Dis Sci. 1984; 29(12):1137-1141.
- Liu CL, Fan ST, Lo CM et al. Management of spontaneous rupture of hepatocellular carcinoma: single-center experience. J Clin Oncol. 2001; 19(17):3725- 3732.
- Leung CS, Tang CN, Fung KH et al. A retrospective review of transcatheter hepatic arterial embolization for ruptured hepatocellular carcinoma. J R Coll Surg Edinb. 2002; 47(5):685-688.
- Polat KY, Akcay MN, Aydınlı B et al. Spontaneous rupture of hepatocelluler carcinoma: a case report and review of literature. Int J Clin Pract Suppl 2005; (147):103-5.
- Hiroyuki Kirikoshi, Satoru Saito, Masato Yoneda et al. Outcomes and factors influencing survival in cirrhotic cases with spontaneous rupture of hepatocellular carcinoma: a multicenter study. BMC Gastroenterology 2009; 30(9): 29
- Zhu LX, Wang GS, Fan ST. Spontaneous rupture of hepatocellular carcinoma. Br J Surg 1996; 83(5): 602–7.
- Zhu LX, Geng XP, Fan ST. Spontaneous rupture of hepatocellular carcinoma and vascular injury. Arch Surg 2001; 136(6): 682–7.
- Vivarelli M, Cavallari A, Bellusci R et al. Ruptured hepatocellular carcinoma: an important cause of spontaneous haemoperitoneum in Italy. Eur J Surg. 1995;161(12): 881-886.
- Miyamoto M, Sudo T, Kuyama T. Spontaneous rupture of hepatocellular carcinoma: A review of 172 Japanese cases. Am J Gastroenterol 1991; 86(1): 67-71.
- Pombo F, Arrojo L, Perez Fontan J. Hemoperitoneum secondary to spontaneous rupture of hepatocelluar carcinoma: CT diagnosis. Clin Radiol 1991; 43(5): 321-322.
- Tan FL, Tan YM, Chung AY et al. Factors affecting early mortality in spontaneous rupture of hepatocellular carsinoma. ANZ J Surg 2006, 76(6): 448-452.
- Buczkowski AK, Kim PT, Ho SG et al. Multidisciplinary management of ruptured hepatocellular carcinoma. J Gastrointest Surg 2006;10(3): 379-86.
- Lau KY, Wong TP, Wong WW et al. Emergency embolization of spontaneous ruptured hepatocellular carcinoma: correlation between survival and Child-Pugh classification. Australas Radiol 2003, 47(3): 231-235.
Öz
Spontan rüptür hepatosellüler karsinomun sıklıkla mortal bir komplikasyonudur. Cerrahi girişim ve arteriel embolizasyon seçilmiş vakalarda ana tedavi seçenekleri olsa da sadece konservatif tedavi ile hayatta kalan vakalar da bulunmaktadır. Bu yazıda mortal olmayan bir hepatosellüler karsinom rüptürü vakası sunulmuştur. Vaka karın ağrısı ve hemodinamik şok tablosunda acile başvurmuş 67 yaşında bir erkekti, hastanın alkolik karaciğer sirozu ve hepatosellüler karsinom tanıları bilinmekteydi. Spontan hepatosellüler karsinom rüptürü ihtimali hastanın karın ağrısı sonrası gelişen şok tablosu nedeniyle düşünüldü, asit sıvısının kanlı olması ve batın tomografisinde bunu destekleyen bulgular olması ile tanı kesinleşti. Konservatif medikal tedavi ile yoğun bakım şartlarında izlenen hastanın şok tablosu saatler içinde düzeldi ve başvurusundan12 gün sonra taburcu edildi
Anahtar Kelimeler
Kaynakça
- Llovet JM, Burroughs A, Bruix J. Hepatocellular carcinoma. Lancet. 2003; 362(9399):1907-1917.
- Vergara V, Muratore A, Bouzari H et al. Spontaneous rupture of hepatocellular carcinoma: surgical resection and long-term survival. Eur J Surg Oncol. 2000; 26(8):770-772.
- Nouchi T, Nishimura M, Maeda M et al. Transcatheter arterial embolization of ruptured hepatocellular carcinoma associated with liver cirrhosis. Dig Dis Sci. 1984; 29(12):1137-1141.
- Liu CL, Fan ST, Lo CM et al. Management of spontaneous rupture of hepatocellular carcinoma: single-center experience. J Clin Oncol. 2001; 19(17):3725- 3732.
- Leung CS, Tang CN, Fung KH et al. A retrospective review of transcatheter hepatic arterial embolization for ruptured hepatocellular carcinoma. J R Coll Surg Edinb. 2002; 47(5):685-688.
- Polat KY, Akcay MN, Aydınlı B et al. Spontaneous rupture of hepatocelluler carcinoma: a case report and review of literature. Int J Clin Pract Suppl 2005; (147):103-5.
- Hiroyuki Kirikoshi, Satoru Saito, Masato Yoneda et al. Outcomes and factors influencing survival in cirrhotic cases with spontaneous rupture of hepatocellular carcinoma: a multicenter study. BMC Gastroenterology 2009; 30(9): 29
- Zhu LX, Wang GS, Fan ST. Spontaneous rupture of hepatocellular carcinoma. Br J Surg 1996; 83(5): 602–7.
- Zhu LX, Geng XP, Fan ST. Spontaneous rupture of hepatocellular carcinoma and vascular injury. Arch Surg 2001; 136(6): 682–7.
- Vivarelli M, Cavallari A, Bellusci R et al. Ruptured hepatocellular carcinoma: an important cause of spontaneous haemoperitoneum in Italy. Eur J Surg. 1995;161(12): 881-886.
- Miyamoto M, Sudo T, Kuyama T. Spontaneous rupture of hepatocellular carcinoma: A review of 172 Japanese cases. Am J Gastroenterol 1991; 86(1): 67-71.
- Pombo F, Arrojo L, Perez Fontan J. Hemoperitoneum secondary to spontaneous rupture of hepatocelluar carcinoma: CT diagnosis. Clin Radiol 1991; 43(5): 321-322.
- Tan FL, Tan YM, Chung AY et al. Factors affecting early mortality in spontaneous rupture of hepatocellular carsinoma. ANZ J Surg 2006, 76(6): 448-452.
- Buczkowski AK, Kim PT, Ho SG et al. Multidisciplinary management of ruptured hepatocellular carcinoma. J Gastrointest Surg 2006;10(3): 379-86.
- Lau KY, Wong TP, Wong WW et al. Emergency embolization of spontaneous ruptured hepatocellular carcinoma: correlation between survival and Child-Pugh classification. Australas Radiol 2003, 47(3): 231-235.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Case Report |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Mart 2012 |
| Yayımlandığı Sayı | Yıl 2012Sayı: 1 |