ObjectiveTo study the mechanism, diagnosis and treatment of spontaneous rupture of hepatocellular carcinoma (HCC) for the purpose of screening out the effective methods of diagnosis and treatment. MethodsArticles have been reviewed to find out the difference among many kinds of diagnosis and treatment. ResultsThe mechanism of spontaneous rupture was not clear. Possible factors included tumor necrosis, coagulopathy, cirrhosis and portal hypertension. Diagnosis of spontaneous rupture of HCC can be made by abdominal paracentesis, ultrasonography and CT. Judging from the reported results the first choice of emergency treatment for hemostasis was transcatheter arterial embolization (TAE). The rational treatment of patients with ruptured HCC was TAE followed by hepatectomy if the lesion was resectable. ConclusionThe prognosis of patients with ruptured HCC could be improved if the correct diagnosis and treatment can be adopted.
Citation： ZHU Lixin,GENG Xiaoping.. Diagnosis and Treatment of Spontaneous Rupture of Hepatocellular Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2002, 9(6): 448-450. doi: Copy
| 1. | Miyamoto M, Sudo T, Kuyama T. Spontaneous rupture of hepatocellular carcinoma： a review of 172 Japanese cases [J]. Am J Gastroenterol, 1991; 86(1)∶67. |
| 2. | Ong GB, Chu EPH, Yu FYK, et al. Spontaneous rupture of hepatocellular carcinoma [J]. Br J Surg, 1965; 52(2)∶123. |
| 3. | Chearanai O, Plengvanit U, Asavanich C, et al. Spontaneous rupture of primary hepatoma: report of 63 cases with particular reference to the pathogenesis and rationale treatment by hepatic artery ligation.Cancer [J]. Cancer, 1983; 51(8)∶1532. |
| 4. | Lai ECS, Wu KM, Choi TK, et al. Spontaneous rupture of hepatocellular carcinoma： an appraisal of surgical treatment [J]. Ann Surg, 1989; 210(1)∶24. |
| 5. | Kanematsu M, Imaeda T, Yamawaki Y, et al. Rupture of hepatocellular carcinoma： predictive value of CT findings [J]. Am J Roentgenol, 1992; 158(6)∶1247. |
| 6. | Nagasue N, Inokuchi K. Spontaneous and traumatic rupture of hepatoma [J]. Br J Surg, 1979; 66(4)∶248. |
| 7. | Kew MC, Hodkinson J. Rupture of hepatocellular carcinoma as a result of blunt abdominal trauma [J]. Am J Gastroenterol, 1991; 86(8)∶1083. |
| 8. | Hermann RE, David TE. Spontaneous rupture of the liver caused by hepatomas [J]. Surgery, 1973; 74(5)∶715. |
| 9. | Ho J, Wu PC, Kung TM. An autopsy study of hepatocellular carcinoma in Hong Kong [J]. Pathology, 1981; 13(3)∶409. |
| 10. | Schmidt G. Hepatocellular carcinoma： a possible complication of oral contraceptive steroids [J]. Med J Aust, 1977; 1(7)∶215. |
| 11. | Hromas RA, Srigley J, Murray JL. Clinical and pathological comparison of young adult women with hepatocellular carcinoma with and without exposure to oral contraceptives [J]. Am J Gastroenterol, 1985; 80(6)∶479. |
| 12. | Balasegaram M. Spontaneous intraperitoneal rupture of primary livercell carcinoma [J]. Aust N Z J Surg, 1968; 37(4)∶332. |
| 13. | Nagasue N, Inokuchi K, Kobayashi M, et al. Hepatoportal arteriovenous fistula in primary carcinoma of the liver [J]. Surg Gynecol Obstet, 1977; 145(4)∶504. |
| 14. | Dewar GA, Griffin SM, Ku KW, et al. Management of bleeding liver tumours in Hong Kong [J]. Br J Surg, 1991; 78(4)∶463. |
| 15. | Chen MF, Hwang TL, Jeng LB, et al. Surgical treatment for spontaneous rupture of hepatocellular carcinoma [J]. Surg Gynecol Obstet, 1988; 167(2)∶99. |
| 16. | 朱立新，耿小平，范上达. 肝癌自发性破裂与抗原抗体复合物血管壁沉积 [J].中华肝胆外科杂志, 2001； 7(11)∶674. |
| 17. | Zhu LX, Geng XP, Fan ST. Spontaneous rupture of hepatocellular carcinoma and vascular injury [J]. Arch Surg，2001; 136(6)∶682. |
| 18. | Chen MF, Jan YY, Lee TY. Transcatheter hepatic arterial embolization followed by hepatic resection for the spontaneous rupture of hepatocellular carcinoma [J]. Cancer, 1986; 58(2)∶332. |
| 19. | Mokka R, Seppala A, Huttunen R, et al. Spontaneous rupture of liver tumours [J]. Br J Surg, 1976; 63(9)∶715. |
| 20. | Xu HS, Yan JB. Conservative management of spontaneous ruptured hepatocellular carcinoma [J]. Am Surg, 1994; 60(8)∶629. |
| 21. | Hirai K, Kawazoe Y, Yamashita K, et al. Transcatheter arterial embolization for spontaneous rupture of hepatocellular carcinoma [J]. Am J Gastroenterol, 1986; 81(4)∶275. |
| 22. | Sato Y, Fujiwara K, Furui S, et al. Benefit of transcatheter arterial embolization for ruptured hepatocellular carcinoma complicating liver cirrhosis [J]. Gastroenterology, 1985; 89(1)∶157. |
| 23. | Corr P, Chan M, Lau WY, et al. The role of hepatic arterial embolization in the management of ruptured hepatocellular carcinoma [J]. Clin Radiol, 1993; 48(3)∶163. |
| 24. | Pombo F, Arrojo L, PerezFontan J. Haemoperitoneum secondary to spontaneous rupture of hepatocellular carcinoma： CT diagnosis [J]. Clin Radiol, 1991; 43(5)∶321. |
| 25. | Hsieh JS, Huang CJ, Huang YS, et al. Intraperitoneal hemorrhage due to spontaneous rupture of hepatocellular carcinoma： treatment by hepatic arterial embolization [J]. Am J Roentgenol, 1987; 149(4)∶715. |
| 26. | Ong GB, Taw JL. Spontaneous rupture of hepatocellular carcinoma [J]. Br Med J, 1972; 4(833)∶146. |
| 27. | Inoue S, Nagao T, Wakabayashi T, et al. Spontaneous rupture of hepatocellular carcinoma： an approach with delayed hepatectomy [J]. Surg Today, 1992; 22(5)∶474. |
| 28. | Sunderland GT, Chisholm EM, Lau WY, et al. Alcohol injection： a treatment for ruptured hepatocellular carcinoma [J]. Surg Oncol, 1992; 1(1)∶61. |
| 29. | Palol JP, Flament JB, Delattre JF. Spontaneous haemoperitoneum through rupture of a primary malignant tumour of the liver [J]. Dig Surg, 1985; 2(8)∶40. |
| 30. | Plengvanit U, Chearanai O, Sindhvananda K, et al. Collateral arterial blood supply of the liver after hepatic artery ligation, angiographic study of twenty patients [J]. Ann Surg, 1972; 175(1)∶105. |
| 31. | Okazaki M, Higashihara H, Koganemaru F, et al. Intraperitoneal hemorrhage from hepatocellular carcinoma: emergency chemoembolization or embolization [J]. Radiology, 1991; 180(3)∶647. |
| 32. | Ngan H, Lai CL, Fan ST, et al. Treatment of inoperable hepatocellular carcinoma by transcatheter arterial chemoembolization using an emulsion of cisplatin in iodized oil and gelfoam [J]. Clin Radiol, 1993; 47(5)∶315. |
| 33. | Ito K, Kusunoki H, Okamoto E, et al. Intraarterial alcoholization of advanced hepatocellular carcinoma [J]. Cancer Chemother Pharmacol, 1994; 33(Suppl)∶s42. |
- 1. Miyamoto M, Sudo T, Kuyama T. Spontaneous rupture of hepatocellular carcinoma： a review of 172 Japanese cases [J]. Am J Gastroenterol, 1991; 86(1)∶67.
- 2. Ong GB, Chu EPH, Yu FYK, et al. Spontaneous rupture of hepatocellular carcinoma [J]. Br J Surg, 1965; 52(2)∶123.
- 3. Chearanai O, Plengvanit U, Asavanich C, et al. Spontaneous rupture of primary hepatoma: report of 63 cases with particular reference to the pathogenesis and rationale treatment by hepatic artery ligation.Cancer [J]. Cancer, 1983; 51(8)∶1532.
- 4. Lai ECS, Wu KM, Choi TK, et al. Spontaneous rupture of hepatocellular carcinoma： an appraisal of surgical treatment [J]. Ann Surg, 1989; 210(1)∶24.
- 5. Kanematsu M, Imaeda T, Yamawaki Y, et al. Rupture of hepatocellular carcinoma： predictive value of CT findings [J]. Am J Roentgenol, 1992; 158(6)∶1247.
- 6. Nagasue N, Inokuchi K. Spontaneous and traumatic rupture of hepatoma [J]. Br J Surg, 1979; 66(4)∶248.
- 7. Kew MC, Hodkinson J. Rupture of hepatocellular carcinoma as a result of blunt abdominal trauma [J]. Am J Gastroenterol, 1991; 86(8)∶1083.
- 8. Hermann RE, David TE. Spontaneous rupture of the liver caused by hepatomas [J]. Surgery, 1973; 74(5)∶715.
- 9. Ho J, Wu PC, Kung TM. An autopsy study of hepatocellular carcinoma in Hong Kong [J]. Pathology, 1981; 13(3)∶409.
- 10. Schmidt G. Hepatocellular carcinoma： a possible complication of oral contraceptive steroids [J]. Med J Aust, 1977; 1(7)∶215.
- 11. Hromas RA, Srigley J, Murray JL. Clinical and pathological comparison of young adult women with hepatocellular carcinoma with and without exposure to oral contraceptives [J]. Am J Gastroenterol, 1985; 80(6)∶479.
- 12. Balasegaram M. Spontaneous intraperitoneal rupture of primary livercell carcinoma [J]. Aust N Z J Surg, 1968; 37(4)∶332.
- 13. Nagasue N, Inokuchi K, Kobayashi M, et al. Hepatoportal arteriovenous fistula in primary carcinoma of the liver [J]. Surg Gynecol Obstet, 1977; 145(4)∶504.
- 14. Dewar GA, Griffin SM, Ku KW, et al. Management of bleeding liver tumours in Hong Kong [J]. Br J Surg, 1991; 78(4)∶463.
- 15. Chen MF, Hwang TL, Jeng LB, et al. Surgical treatment for spontaneous rupture of hepatocellular carcinoma [J]. Surg Gynecol Obstet, 1988; 167(2)∶99.
- 16. 朱立新，耿小平，范上达. 肝癌自发性破裂与抗原抗体复合物血管壁沉积 [J].中华肝胆外科杂志, 2001； 7(11)∶674.
- 17. Zhu LX, Geng XP, Fan ST. Spontaneous rupture of hepatocellular carcinoma and vascular injury [J]. Arch Surg，2001; 136(6)∶682.
- 18. Chen MF, Jan YY, Lee TY. Transcatheter hepatic arterial embolization followed by hepatic resection for the spontaneous rupture of hepatocellular carcinoma [J]. Cancer, 1986; 58(2)∶332.
- 19. Mokka R, Seppala A, Huttunen R, et al. Spontaneous rupture of liver tumours [J]. Br J Surg, 1976; 63(9)∶715.
- 20. Xu HS, Yan JB. Conservative management of spontaneous ruptured hepatocellular carcinoma [J]. Am Surg, 1994; 60(8)∶629.
- 21. Hirai K, Kawazoe Y, Yamashita K, et al. Transcatheter arterial embolization for spontaneous rupture of hepatocellular carcinoma [J]. Am J Gastroenterol, 1986; 81(4)∶275.
- 22. Sato Y, Fujiwara K, Furui S, et al. Benefit of transcatheter arterial embolization for ruptured hepatocellular carcinoma complicating liver cirrhosis [J]. Gastroenterology, 1985; 89(1)∶157.
- 23. Corr P, Chan M, Lau WY, et al. The role of hepatic arterial embolization in the management of ruptured hepatocellular carcinoma [J]. Clin Radiol, 1993; 48(3)∶163.
- 24. Pombo F, Arrojo L, PerezFontan J. Haemoperitoneum secondary to spontaneous rupture of hepatocellular carcinoma： CT diagnosis [J]. Clin Radiol, 1991; 43(5)∶321.
- 25. Hsieh JS, Huang CJ, Huang YS, et al. Intraperitoneal hemorrhage due to spontaneous rupture of hepatocellular carcinoma： treatment by hepatic arterial embolization [J]. Am J Roentgenol, 1987; 149(4)∶715.
- 26. Ong GB, Taw JL. Spontaneous rupture of hepatocellular carcinoma [J]. Br Med J, 1972; 4(833)∶146.
- 27. Inoue S, Nagao T, Wakabayashi T, et al. Spontaneous rupture of hepatocellular carcinoma： an approach with delayed hepatectomy [J]. Surg Today, 1992; 22(5)∶474.
- 28. Sunderland GT, Chisholm EM, Lau WY, et al. Alcohol injection： a treatment for ruptured hepatocellular carcinoma [J]. Surg Oncol, 1992; 1(1)∶61.
- 29. Palol JP, Flament JB, Delattre JF. Spontaneous haemoperitoneum through rupture of a primary malignant tumour of the liver [J]. Dig Surg, 1985; 2(8)∶40.
- 30. Plengvanit U, Chearanai O, Sindhvananda K, et al. Collateral arterial blood supply of the liver after hepatic artery ligation, angiographic study of twenty patients [J]. Ann Surg, 1972; 175(1)∶105.
- 31. Okazaki M, Higashihara H, Koganemaru F, et al. Intraperitoneal hemorrhage from hepatocellular carcinoma: emergency chemoembolization or embolization [J]. Radiology, 1991; 180(3)∶647.
- 32. Ngan H, Lai CL, Fan ST, et al. Treatment of inoperable hepatocellular carcinoma by transcatheter arterial chemoembolization using an emulsion of cisplatin in iodized oil and gelfoam [J]. Clin Radiol, 1993; 47(5)∶315.
- 33. Ito K, Kusunoki H, Okamoto E, et al. Intraarterial alcoholization of advanced hepatocellular carcinoma [J]. Cancer Chemother Pharmacol, 1994; 33(Suppl)∶s42.