Traumatic Rupture of Hepatocellular Carcinoma

ABSTRACT

A 45-year-old man presented at the emergency department with severe whole abdominal pain. He was struck on the abdomen by a soccer ball in the soccer game 12 hours ago. Initial vital signs were unstable, but stabilized soon after fluid resuscitation. CT scans were performed to diagnose injury to the intraabdominal organs. CT scans showed hemoperitoneum and rupture of hepatocellular carcinoma (HCC). Transarterial chemoembolization and catheter drainage were performed. He was discharged on the 22th day. Rupture of HCC is mostly occurred in the advanced stage of HCC, but very rarely happened after abdominal trauma. Treatment of choice for traumatic rupture of HCC was not established yet. In our case, the patient was cured by transarterial chemoembolization without laparotomy. Considering that the treatment for traumatic liver injury is supportive care or laparotomy, emergency physician should remember that traumatic rupture of HCC also can cause hemoperitoneum after abdominal trauma.