Ann Hepatobiliary Pancreat Surg.  2018 Nov;22(4):416-418. 10.14701/ahbps.2018.22.4.416.

Acute haemoperitoneum due to small bowel metastases from hepatocellular carcinoma in a long term survivor following previous rupture

• Shelat VG
• Giron DM
• Oo AM

• KMID: 2427375
• DOI: http://doi.org/10.14701/ahbps.2018.22.4.416

Abstract

We report a 75-year old patient, presenting with acute abdomen and hemorrhagic shock. He provided history of right hemihepatectomy performed 5 years ago, for ruptured hepatocellular carcinoma on a background of Hepatitis B virus associated liver cirrhosis. A computerized tomography scan showed 5 cm-sized mass exophytic lesion, in the small bowel with haemoperitoneum. An emergency laparotomy and small bowel resection, with primary anastomosis was performed. Histology showed Hep Par 1 stain reactive cells, on the serosal surface of the small bowel. A final diagnosis of metastatic hepatocellular carcinoma was made.

Keyword

Haemoperitoneum; Hepatocellular carcinoma; Metastasis; Rupture

MeSH Terms

Abdomen, Acute
Carcinoma, Hepatocellular*
Diagnosis
Emergencies
Hepatitis B virus
Humans
Laparotomy
Liver Cirrhosis
Neoplasm Metastasis*
Rupture*
Shock, Hemorrhagic
Survivors*

Figure

• 

  Fig. 1 Computed tomography showing a 5 cm-sized enhancing mass (arrow) in the right flank adherent to small bowel.

• 

  Fig. 2 Microphotography showing low power magnification showing normal intestinal mucosa (black arrow) and deposits of hepatocellular carcinoma on serosal surface (yellow arrow).

• 

  Fig. 3 Immunohistochemical stain finding: Hep Par 1 stain confirming presence of hepatocytes.

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