Diagnosis and treatment of spontaneous rupture of liver carcinoma with bleeding

Abstract

AIM: To study the diagnosis and treatment for spontaneous rupture of liver carcinoma with bleeding.

METHODS: 22 patients (19 males 86%, and 3 females 14%) , with spontaneous rupture of liver carcinoma with bleeding treated between 1980 and 1995 were reviewed. The patients consisted of exploratory laparotomy was performed in 16 cases (73%), of them, hepatectomy in 5 cases (31%), hepatic artery ligation in 2 cases (13%), suture and packing with omentum in 9 cases (56%), and conservative therapy in 6 cases (27%).

RESULTS: The survival time of the 16 patients with operation ran ged from 1 to 15 mo, with a mean survival of 5 mo, and the longest one survived 15 mo after liver resection. In non-resectable cases conservative cases, the survival time was only 1 to 3 mo.

CONCLUSION: Abdominal paracentesis, along with a physical examination of the abdomen will be useful in diagnosis of spontaneous rupture of liver carcinoma. The selection of the procedure for the treatment of spontaneous rupture of liver carcinoma will be decided, according the patient's condition, such as hepatic function, extent of the hepatoma. It is very important to accomplish hemostasis and reverse hemorragic shock. The therapeutic procedures including hepatectomy, hepatic artery ligation, suture and packing with omentum may be used in some late cases, especially in the aged.

Key Words: Liver neoplasms/diagnosis, Liver neoplasms/therapy, Spontaneous rupture