ANALYSIS OF SPONTANEOUS RUPTURE OF HEPATOCELLULAR CARCINOMA WITH SPECIAL REFERENCE TO SPONTANEOUS HEMOSTASIS

Abstract

There are many reports describing that spontaneous rupture of hepatocellular carcinoma necessitated emergency treatment as acute abdomen. However, we obtained interesting and specific findings as a mechanism of spontaneous hemostasis of the ruptured carcinoma when operation was performed after spontaneous hemostasis. Ten cases of spontaneous rupture of hepatocellular carcinoma, experienced at Iwakuni National Hospital from January 1981 to December 1991, were divided into 3 groups; the conservative therapy group (group I), emergent transcatheter arterial embolization group (group II) and operative group followed by spontaneous hemostasis (group III). The diagnostic methods included the confirmation of bleeding by abdominal puncture, autopsy and/or imaging diagnosis. The condition of group III was better than group I and group II in the hepatic functional reserve and general status. The operative finding showed that the perforated portions of the carcinoma were covered with surrouding tissues such as the greater omentum, diaphragm and lesser omentum. We think that bleeding is stopped in some cases of group II without the emergent transcatheter arterial embolization. It might be premature determination that emergent transcatheter arterial embolization contributed to the hemostasis in all cases.