Srpski arhiv za celokupno lekarstvo 2013 Volume 141, Issue 1-2, Pages: 95-99
https://doi.org/10.2298/SARH1302095D
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Spontaneous rupture of giant liver hemangioma: Case report
Doklestić Krstina 
(Klinički centar Srbije, Klinika za urgentnu hirurgiju, Beograd + Medicinski fakultet, Beograd)
Stefanović Branislav (Klinički centar Srbije, Klinika za urgentnu hirurgiju, Beograd + Medicinski fakultet, Beograd)
Karamarković Aleksandar (Klinički centar Srbije, Klinika za urgentnu hirurgiju, Beograd + Medicinski fakultet, Beograd)
Bumbaširević Vesna (Medicinski fakultet, Beograd + Klinički centar Srbije, Centar za anesteziju, Služba anestezije Urgentnog centra, Beograd)
Stefanović Branislava (Služba anestezije Urgentnog centra, Centar za anesteziju, Klinički centar Srbije, Beograd)
Gregorić Pavle (Klinički centar Srbije, Klinika za urgentnu hirurgiju, Beograd + Medicinski fakultet, Beograd)
Radenković Dejan (Klinički centar Srbije, Klinika za urgentnu hirurgiju, Beograd + Medicinski fakultet, Beograd)
Bajec Đorđe (Klinički centar Srbije, Klinika za urgentnu hirurgiju, Beograd + Medicinski fakultet, Beograd)
Introduction. Hemangioma is the most frequent benign solid tumor of the
liver. It is well known that a giant liver hemangioma carries the risk of
spontaneous rupture, followed by hemoperitoneum and hemorrhagic shock with
possible fatal outcome. Case Outline. This is a case report of the
spontaneous rupture of a giant cavernous hemangioma of the liver in an
85-year old patient. The patient was presented with abdominal pain and
hemorrhagic shock. Emergency ultrasonography and computed tomography of the
abdomen showed a heterogeneous ruptured solid tumor of the right liver lobe,
multiple cysts in the left lobe and massive hemoperitoneum. The patient was
successfully managed by immediate exploratory laparotomy, surgical
enucleation of the hemangioma under intermittent inflow vascular occlusion,
temporary perihepatic packing and planned second look relaparotomy.
Conclusion. Immediate surgical procedure is indicated mandatory in unstable
patients with a ruptured giant hemangioma of the liver. Surgical enucleation
under intermittent inflow vascular occlusion and temporary perihepatic
packing could be a life-saving procedure in those patients.
Keywords: liver hemangioma, spontaneous rupture, hemoperitoneum