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Unusual presentation of more common disease/injury
Case report
Spontaneous hepatic haemorrhage secondary to ruptured hepatocellular adenoma in a young male patient
  1. Peter Daechul Yoon1,
  2. Andy Ze Lin Chen1,
  3. David Tovmassian1 and
  4. Henry Pleass1,2
  1. 1Department of Surgery, Westmead Hospital, Westmead, New South Wales, Australia
  2. 2Westmead Clinical School, The University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr Peter Daechul Yoon; petyoon{at}gmail.com

Abstract

A 27-year-old man presented with acute right upper quadrant abdominal pain and vomiting. He was clinically in hypovolaemic shock. Investigations revealed normocytic anaemia with a normal bilirubin and moderate liver function test abnormalities. CT abdomen and pelvis demonstrated haemoperitoneum and a large solitary hepatic mass in segments V and VI, suspicious for a ruptured hepatic tumour. Massive transfusion protocol was commenced and angioembolisation of the inferior branch of the right hepatic artery was undertaken. Despite this, his haemorrhagic shock was resistant to resuscitation. Thus, he underwent emergent exploratory laparotomy, which resulted in segments V and VI liver resection and packing. Re-look laparotomy 2 days following initial exploration was performed where haemostasis was confirmed. Histopathology revealed a ruptured well-differentiated hepatocellular adenoma. The patient made a good recovery following a 2-week admission.

  • liver disease
  • gastrointestinal surgery

https://doi.org/10.1136/bcr-2020-235966

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    Footnotes

    • Contributors PDY conducted the literature search and manuscript write-up, AZLC assisted with the literature search and reviewed the manuscript, DT reviewed the manuscript, HP provided supervision and manuscript review.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.