The Effective Method to Control Bleeding of the Ruptured Hepatic Hemangioma
Introduction: Hepatic hemangioma is the most common benign tumor in the liver. Although intra-abdominal bleeding associated with its rupture is rare, but life-threatening. Here we report a case of ruptured hepatic hemangioma and applied method for controlling its bleeding. Case Report: The patient was a 45-year-old man who was referred after crashing his motorcycle into a car. The patient’s primary survey revealed intra-abdominal free fluid, but stable vital signs. Thirty minutes later, the patient’s systolic blood pressure dropped to 85 mmHg. Laparotomy was performed a large hemangioma was observed involving almost the entire left lobe of the liver. Using a liver needle and 2-0 chromic suture, we entered the hemangioma at the perforation site of the lower portion of the liver and exit from the upper part. Then, we entered the upper part of the liver and exited from the lower part, and then it was tied. According to this approach, hemangioma was packed from the lower segment of the liver. Conclusion: In this case, the patient’s abdomen was primarily closed without extra packing and embolization. The proposed method thus may be more effective compared to conventionally used methods.
2. Mannino M, Toro A, Palumbo V, Carlo ID. Hepatic hemangiomas of the liver: when operate and with which vascular exclusion. Ann Laparosc Endosc Surg. 2018;3:9.
3. Corigliano N, Mercantini P, Amodio PM, Balducci G, Caterino S, Ramacciato G, et al. Hemoperitoneum from a spontaneous rupture of a giant hemangioma of the liver: report of a case. Surg today. 2003;33(6):459-63.
4. Beatty JS, Mitchell JW, Holsten SB, Ferdinand CH. Traumatic rupture of a previously undiagnosed giant hepatic hemangioma. Am Surg. 2013;79(9):e314-5.
5. Kang LY, Huang FD, Liu YY. Blunt abdominal injury with rupture of giant hepatic cavernous hemangioma and laceration of the spleen. Hepatobiliary Pancreat Dis Int. 2015;14(1):109-10.
6. Guillen-Paredes MP, Martinez Fernandez J, Morales Gonzalez A, Pardo-Garcia JL. Spontaneous rupture of a liver hemangioma. A case report. Rev Esp Enferm Dig. 2016;108(7):431.