CASE REPORTS   

Chirurgia 2012 October;25(5):397-400

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: Italian

Spontaneous rupture of a giant hepatic hemangioma: case report

Lo Storto G., Frasca M., Cinquesanti L., Melino R., Montini F., Di Millo M., Di Gioia G., Tricarico F.

Dipartimento di Chirurgia Generale II ad Indirizzo d’Urgenza, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Foggia, Foggia, Italia

Hemangioma is the most common benign tumor of liver and it is often small in size and asymptomatic. Surgical resection usually should be considered for giant hepatic hemangioma (larger than 5 cm), in case of clinical disorders and complications (spontaneous or traumatic rupture, intratumoral bledding). The type of surgical treatment (resection vs enucleation) depends on size and location of the lesion. It’s need to save sound liver as much as possible for benign lesion. The use of intraoperative ultrasonography is needful in liver surgery; it can modify surgical strategy in 35% of cases. We report a case of a 65 year old female patient, affected by spontaneous rupture of a giant hepatic hemangioma. Abdominal ultrasonography and computed tomography showed a intrahepatic bleeding larger than 15 cm, on a lot of the left liver. The patient underwent preoperative transcatheter embolization of the left hepatic artery to top the cause of the bleeding, prepare the patient for an operation of choice, and reduce the intraoperative bleeding. The surgery treatment was a left hepatectomy. The postoperative period was regular; the patient was discharged in eighth day of treatment. Histology confirmed the diagnosis of intraparenchymal bleeding of an hepatic hemangioma.