Spontaneous hepatic haemorrhage: a review of pathogenesis, aetiology and treatment

Srinivasa, Sanket; Lee, Wai Gin; Aldameh, Ali; Koea, Jonathan

doi:10.1111/hpb.12474

Cited by 44 publications

(56 citation statements)

References 61 publications

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“…More importantly regression of fibrosis associated with ant-viral therapy is associated with improved liver function. 2,8,9 Spontaneous hemorrhage from the liver occurs evenly from benign or malignant causes, one-third of which are primary liver disease. If the patients presents emergently, angiographic embolization may control the bleeding and allow for elective resection once the sequelae of bleeding have resolved.…”

Section: Discussionmentioning

confidence: 99%

“…In spite of these issues, SHH has never been comprehensively reviewed possibly because of its rarity, the potentially wide range of underlying conditions. 2,3 A diagnosis of SHH is based on a clinical index of suspicion in patients with a known underlying condition. However, this is not always as straightforward as SHH is a rare complication in patients with connective tissue disease.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Segment V spontaneous hepatic haemorrhage from hepatic cirrhosis: an emergency abdominal surgery case report

Bagus

Andi

2019

Int Surg J

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A spontaneous hepatic haemorrhage (SHH) is a rare condition that results from a breach in the hepatic parenchyma that occurs without an external cause. It is an acute surgical emergency as it results in intra-abdominal bleeding that, if untreated, will progress to haemorrhagic shock and death. The clinical presentation is often non-specific but emergent, and rapid diagnosis and treatment is required, often involving a number of services including interventional radiology, hepatology and surgery. SHH is a rare event most commonly caused by HCC and hepatic adenoma although there are numerous other causative lesions including all recognized benign and malignant hepatic tumours including metastatic cancer. The mechanism of spontaneous bleeding remains unclear but there is evidence for compromised vascular integrity at least in patients with HCC and the incidence of the condition in patients with connective tissue diseases. A diagnosis of SHH is based on a clinical index of suspicion in patients with a known underlying condition. However, this is not always as straightforward as SHH is a rare complication in patients with connective tissue disease. Spontaneous hepatic haemorrhage is one of acute abdominal emergency case with high morbidity and mortality rate. Emergency operation plays an important role in managing this case.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Segment V spontaneous hepatic haemorrhage from hepatic cirrhosis: an emergency abdominal surgery case report

Bagus

Andi

2019

Int Surg J

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“…Tumor size and location, particularly in HCC, do not seem to correlate with the risk of bleeding, as both large, central lesions and small, peripheral lesions have an approximately equal propensity to bleed. 32 The hemorrhage may not even come from the tumor itself; some have suggested that tumoral growth may fracture adjacent liver parenchyma and breach Glisson's capsule from within, thus leading to bleeding. 31 A recent history of blunt trauma may be elicited from patients as the inciting event.…”

Section: Livermentioning

confidence: 99%

Palliative Embolization for Refractory Bleeding

Niekamp

Sheth

Kuban

et al. 2017

Semin intervent Radiol

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Bleeding is a common and often challenging complication of malignancy. Etiologies of hemorrhage in this patient population vary, and bleeding may present as an acute, life-threatening emergency or a chronic, low-volume blood loss. For patients with advanced malignancies, interventions to manage bleeding must be balanced by the patient's life expectancy and quality of life. As such, minimally invasive procedures such as transarterial embolization are useful therapeutic options in appropriately selected patients. There is a rich history of palliative transarterial embolization for refractory bleeding in cancer patients. This technique was first applied in the 1970s and has since become an established treatment tool for malignancy-related bleeding throughout the body. While the preponderance of published data comprised case reports and small retrospective studies, the use of embolization continues to expand as experience grows and techniques are refined. In this review, we summarize the literature and provide our perspective on embolization for refractory bleeding in cancer patients.

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“…Based on the unique feature of imaging, it could be speculated for differential diagnosis that there was intratumoral hemorrhage that was detected as heterogeneously high-intensity regions in the hepatocellular phase of Gd-EOB-DTPA contrast-enhanced MRI. Several types of tumors are known to show hemorrhage in the mass, such as HCC [15] , HCA [16] , metastatic tumors of lung and renal cancers [17] , and angiomyolipoma (AML) [18] . In the present patient, imaging studies revealed no findings of metastatic liver tumor or AML; neither metastatic liver tumor nor AML show any enhancement on Gd-EOB-DTPA in the hepatocellular phase on contrast-enhanced MRI.…”

Section: Hcamentioning

confidence: 99%

Malignant Transformation of Hepatocellular Adenoma

Kwok

Hagiwara²,

Nishida³

et al. 2016

Oncology

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The patient was a 20-year-old male in whom a hepatic hypervascular mass accompanied by intratumoral hemorrhage was detected on examination for epigastric pain. Based on the enlargement of the mass and diagnostic imaging, hepatocellular adenoma (HCA) was suspected and hepatectomy was performed. The lesion was diagnosed as malignant transformation of β-catenin-activated HCA. There are only few reports of cases with malignant transformation of HCA in Japan; it is necessary to accumulate cases to investigate it.

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Spontaneous hepatic haemorrhage: a review of pathogenesis, aetiology and treatment

Abstract: A spontaneous hepatic haemorrhage is an acute presentation of a spectrum of conditions that requires early diagnosis and multidisciplinary management.

Cited by 44 publications

References 61 publications

Segment V spontaneous hepatic haemorrhage from hepatic cirrhosis: an emergency abdominal surgery case report

Segment V spontaneous hepatic haemorrhage from hepatic cirrhosis: an emergency abdominal surgery case report

Palliative Embolization for Refractory Bleeding

Malignant Transformation of Hepatocellular Adenoma

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