Rupture of large liver tumor causing abdominal hemorrhaging

a male patient with a liver tumor of 10 cm, ruptured causing an overflow of about 400 ml of abdominal blood, has just had successful emergency intervention.

One day after endovascular intervention, Mr. Nguyen Trung Kien (42 years old, Vung Tau) is awake, has reduced abdominal pain, can eat normally, is expected to be discharged after 2-3 days.

Earlier (September 20), Mr. Kien went to Tam Anh General Hospital in Ho Chi Minh City for emergency due to severe abdominal pain. The results of ultrasound and CT scan of the abdomen showed that the patient had hepatocellular carcinoma, a large tumor that had ruptured causing hemoperitoneum. BS.CKI Duong Dinh Hoan (Interventional Imaging Unit, Center for Diagnostic Imaging and Interventional Radiology) said that the risk of a second rupture of the tumor was very high. Once broken again, it is life-threatening due to blood loss causing a drop in blood pressure.

"The ruptured liver cancer needs urgent emergency care, if not treated actively, the tumor can continue to burst, causing severe blood loss and possibly death," said Dr. Hoan.

Assessing the emergency situation, doctors performed endovascular interventions to block the blood vessels feeding the tumor, stop bleeding for the patient, and pump chemotherapy to prevent tumor growth. The procedure lasts for 30 minutes.

Images of subhepatic hematoma (left, arrow position) and large liver cancer on CT patient's abdomen (right). Photo: Provided by the hospital

Patient Kien has a long history of chronic hepatitis B virus and is undergoing medical treatment. 2 days before admission, the patient suddenly had severe abdominal pain, increasing gradually, was treated at a local hospital, then transferred to Tam Anh General Hospital in Ho Chi Minh City.

Dr. Hoan added that endovascular intervention is a minimally invasive method, requiring only a small incision in the thigh, the doctors approached to block the arterial branches feeding the tumor, causing bleeding. Then, the doctor injects chemotherapy to treat the tumor and injects embolization materials to block the blood vessel. With a large cancerous tumor like this, the surgeon needs to select deep into the arterial branches that feed the tumor to carry out pumping occlusion so as not to affect the remaining healthy liver parenchyma, reducing the risk of acute liver failure after the procedure. .

The team performed an occlusive intervention for the patient's liver tumor. Photo: Provided by the hospital

The rate of cirrhosis and liver cancer in Vietnam is increasing. Globocan statistics in 2020 show that liver cancer is the leading cause of cancer death in our country, with more than 25,000 cases, accounting for more than 20%.

Treatment of liver cancer is often difficult because patients are detected late. Everyone should have regular health checkups, especially patients with a history of hepatitis B and C infection, drinking a lot of alcohol. When abnormalities are detected in the liver, patients are advised to do intensive tests, CT scans, and magnetic resonance imaging to diagnose lesions. Then, the doctor will have a timely treatment direction; prevent the tumor from getting bigger and bursting, which is life-threatening.