Massive hemorrhage from spontaneous ruptured hepatocellular carcinoma controlled by isoamyl 2-cyanoacrylate: a case report

To report a case of ruptured hepatocellular carcinoma with massive hemoperitoneum which was successfully controlled with isoamyl 2-cyanoacrylate. A 46-year-old Bangladeshi gentleman presented to our casualty complaining of acute abdominal pain and distension, associated with jaundice. Bedside abdominal ultrasound showed multiple focal lesions in the liver with fluid in the abdomen. The patient was vitally unstable, so he was resuscitated and underwent emergency laparotomy for massive hemoperitoneum due to a ruptured tumor nodule. Isoamyl 2-cyanoacrylate was applied to the ruptured nodule which stopped bleeding within 1-2 min. This case shows the effectiveness of isoamyl 2-cyanoacrylate in controlling bleeding in ruptured liver tumors