In the Beginning ... It was Already the End

Abstract

Sometimes, the presentation of some diseases can be fulminating. The authors present the case of a 51-year- old male brought to the emergency department visibly drunk and complaining of abdominal pain. Immediately, the diagnosis of hemorrhagic shock due to an accentuated drop of the hemoglobin level was made. After stabilization, he underwent a computed tomography of the abdomen, revealing a hepatocellular carcinoma with rupture of the Glisson capsule and massive intraperitoneal hemorrhage. With this case, the authors want to bring attention to a rare first presentation of hepatocellular carcinoma with a catastrophic result.

Unusual cause of intraoperative haemorrhage: a lesson for patient counselling

“…Recent case reports have focused on haemorrhage as the first indication of an underlying HCC;12–15 however, as in our case, the majority of cases occur in those with previously diagnosed HCCs 7…”

“…Several articles have highlighted that early diagnosis and intervention in cases of HCC haemorrhage is key to reduce the mortality associated with it 9–12. Furthermore, several case reports described haemorrhage as the first presentation of HCCs,12–15 and the majority of these cases occur in patients who are already aware of their diagnosis 7. However, no literature is available on the effect of preventive patient education on HCC haemorrhage related mortality.…”