Spontaneous Hemoperitoneum Secondary to ...

18.01.2006, 10:19

Spontaneous Hemoperitoneum Secondary to Ruptured Metastasis of an Ileal Carcinoma Solved by Lateral Liver Resection

Articol din publicatia Timisoara Medical Journal nr. 2/2005
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Authors: Octavian Mazilu1, Dorin Grigoras2, Horia Prundeanu1, Flavius Sandra1, Dan Iliescu1, Laurentiu Sima1, Vladimir Fluture1

1 Emergency Surgery Clinic, Timisoara municipal Hospital
2 1st Clinic of Gynecology, Dumitru Popescu Hospital, Timisoara

Correspondence to:
Dr. Octavian Mazilu, Emergency Surgery Clinic, Timisoara Municipal Hospital, Gh. Dima No. 5, 300079, Timisoara
Tel: +40722852410
Email: mazilu_o@yahoo.com

ABSTRACT
Spontaneous ruptures of liver metastases are less reported than those of benign or malign hepatic tumors. In these cases liver resection is indicated in order to ensure hemostasis and not as a curative procedure.
The authors present a 61-year-old patient with ileum carcinoma and multiple liver metastases, admitted for epigastralgia, abdominal distension, asthenia, pallor and significant weight loss. Ultrasound examination showed hepatic metastases in the segments II, III and VIII, of 3, 2 and respectively 3 cm in diameter. The laparotomy revealed a hemoperitoneum secondary to a spontaneous rupture of a liver metastasis from the left lateral lobe. A left lateral liver resection was performed in order to control the hemorrhage and subsequently an ileo-transverso-anastomosis was performed, in order to avoid the partially obstructive ileum tumor. Postoperative recovery was uneventful. In conclusion, liver resection can be performed as a palliative procedure in order to control the hemorrhage secondary to a spontaneous metastasis rupture, and it is considered superior to other haemostatic procedures.
Even if tumor dissemination in the peritoneal cavity is possible during the rupture of a metastasis, the aggressive surgical procedure may ensure a natural course of the disease in these patients.

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