Published online Jul 21, 2013. doi: 10.3748/wjg.v19.i27.4422
Revised: May 15, 2013
Accepted: May 18, 2013
Published online: July 21, 2013
Unlike hepatic haemorrhage following blunt abdominal trauma, spontaneous abdomen bleeding is rare, even in the presence of a hepatocellular adenoma (HA) or carcinoma. However, the diagnosis of a tumour underlying a haematoma after liver trauma is unusual, especially when it occurs more after two years after the accident. Here, we report a case of a ruptured HA due to blunt abdominal trauma. A 36-year-old woman was admitted to our hospital with sudden onset of upper abdominal pain. Her medical history revealed a blunt abdominal trauma two years prior. Initial abdominal computed tomography scan revealed a large haematoma measuring more than 16 cm in diameter in the right lobe of the liver. Magnetic resonance imaging showed haemorrhagic areas and some regions with hepatocyte hyperplasia, suggesting HA. The patient underwent right hepatic lobectomy, and a histopathological examination confirmed a diagnosis of HA. In conclusion, it is important to consider that abdominal trauma may hide old, asymptomatic and not previously detected injuries, as in the case reported.
Core tip: This paper clarifies that surgical liver diseases should be evaluated by experts at specialized centers. In addition, experts should pay attention to unusual situations as reported. Asymptomatic liver tumors are more common than imagined, even when presented underlying other acute disease, such as blunt trauma.