Surgical management of spontaneous ruptured hepatocellular adenoma

Detalhes bibliográficos
Autor(a) principal: Ribeiro Junior, Marcelo Augusto Fontenelle
Data de Publicação: 2009
Outros Autores: Chaib, Eleazar, Saad, William Abrão, D'Albuquerque, Luiz Augusto Carneiro, Cecconello, Ivan
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Clinics
Texto Completo: https://www.revistas.usp.br/clinics/article/view/17944
Resumo: AIMS: Spontaneous ruptured hepatocellular adenoma (SRHA) is a rare life-threatening condition that may require surgical treatment to control hemorrhaging and also stabilize the patient. We report a series of emergency surgeries performed at our institution for this condition. METHODS: We reviewed medical records and radiology files of 28 patients (from 1989 to 2006) with a proven diagnosis of hepatocellular adenoma (HA). Three (10.7%) of 28 patients had spontaneous ruptured hepatocellular adenoma, two of which were associated with intrahepatic hemorrhage while one had intraperitoneal bleeding. Two patients were female and one was male. Both female patients had a background history of oral contraceptive use. Sudden abdominal pain associated with hemodynamic instability occurred in all patients who suffered from spontaneous ruptured hepatocellular adenoma. The mean age was 41.6 years old. The preoperative assessment included liver function tests, ultrasonography and computed tomography. RESULTS: The surgical approaches were as follows: right hemihepatectomy for controlling intraperitoneal bleeding, and right extended hepatectomy and non-anatomic resection of the liver for intrahepatic hemorrhage. There were no deaths, and the postoperative complications were bile leakage and wound infection (re-operation), as well as intraperitoneal abscess (re-operation) and pleural effusion. CONCLUSION: Spontaneous ruptured hepatocellular adenoma may be treated by surgery for controlling hemorrhages and stabilizing the patient, and the decision to operate depends upon both the patient's condition and the expertise of the surgical team.
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spelling Surgical management of spontaneous ruptured hepatocellular adenoma AdenomaSurgeryComplicationsLiver hemorrhageMortality AIMS: Spontaneous ruptured hepatocellular adenoma (SRHA) is a rare life-threatening condition that may require surgical treatment to control hemorrhaging and also stabilize the patient. We report a series of emergency surgeries performed at our institution for this condition. METHODS: We reviewed medical records and radiology files of 28 patients (from 1989 to 2006) with a proven diagnosis of hepatocellular adenoma (HA). Three (10.7%) of 28 patients had spontaneous ruptured hepatocellular adenoma, two of which were associated with intrahepatic hemorrhage while one had intraperitoneal bleeding. Two patients were female and one was male. Both female patients had a background history of oral contraceptive use. Sudden abdominal pain associated with hemodynamic instability occurred in all patients who suffered from spontaneous ruptured hepatocellular adenoma. The mean age was 41.6 years old. The preoperative assessment included liver function tests, ultrasonography and computed tomography. RESULTS: The surgical approaches were as follows: right hemihepatectomy for controlling intraperitoneal bleeding, and right extended hepatectomy and non-anatomic resection of the liver for intrahepatic hemorrhage. There were no deaths, and the postoperative complications were bile leakage and wound infection (re-operation), as well as intraperitoneal abscess (re-operation) and pleural effusion. CONCLUSION: Spontaneous ruptured hepatocellular adenoma may be treated by surgery for controlling hemorrhages and stabilizing the patient, and the decision to operate depends upon both the patient's condition and the expertise of the surgical team. Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2009-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/1794410.1590/S1807-59322009000800011Clinics; Vol. 64 No. 8 (2009); 775-779 Clinics; v. 64 n. 8 (2009); 775-779 Clinics; Vol. 64 Núm. 8 (2009); 775-779 1980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/17944/20009Ribeiro Junior, Marcelo Augusto FontenelleChaib, EleazarSaad, William AbrãoD'Albuquerque, Luiz Augusto CarneiroCecconello, Ivaninfo:eu-repo/semantics/openAccess2012-05-22T18:47:12Zoai:revistas.usp.br:article/17944Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2012-05-22T18:47:12Clinics - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Surgical management of spontaneous ruptured hepatocellular adenoma
title Surgical management of spontaneous ruptured hepatocellular adenoma
spellingShingle Surgical management of spontaneous ruptured hepatocellular adenoma
Ribeiro Junior, Marcelo Augusto Fontenelle
Adenoma
Surgery
Complications
Liver hemorrhage
Mortality
title_short Surgical management of spontaneous ruptured hepatocellular adenoma
title_full Surgical management of spontaneous ruptured hepatocellular adenoma
title_fullStr Surgical management of spontaneous ruptured hepatocellular adenoma
title_full_unstemmed Surgical management of spontaneous ruptured hepatocellular adenoma
title_sort Surgical management of spontaneous ruptured hepatocellular adenoma
author Ribeiro Junior, Marcelo Augusto Fontenelle
author_facet Ribeiro Junior, Marcelo Augusto Fontenelle
Chaib, Eleazar
Saad, William Abrão
D'Albuquerque, Luiz Augusto Carneiro
Cecconello, Ivan
author_role author
author2 Chaib, Eleazar
Saad, William Abrão
D'Albuquerque, Luiz Augusto Carneiro
Cecconello, Ivan
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Ribeiro Junior, Marcelo Augusto Fontenelle
Chaib, Eleazar
Saad, William Abrão
D'Albuquerque, Luiz Augusto Carneiro
Cecconello, Ivan
dc.subject.por.fl_str_mv Adenoma
Surgery
Complications
Liver hemorrhage
Mortality
topic Adenoma
Surgery
Complications
Liver hemorrhage
Mortality
description AIMS: Spontaneous ruptured hepatocellular adenoma (SRHA) is a rare life-threatening condition that may require surgical treatment to control hemorrhaging and also stabilize the patient. We report a series of emergency surgeries performed at our institution for this condition. METHODS: We reviewed medical records and radiology files of 28 patients (from 1989 to 2006) with a proven diagnosis of hepatocellular adenoma (HA). Three (10.7%) of 28 patients had spontaneous ruptured hepatocellular adenoma, two of which were associated with intrahepatic hemorrhage while one had intraperitoneal bleeding. Two patients were female and one was male. Both female patients had a background history of oral contraceptive use. Sudden abdominal pain associated with hemodynamic instability occurred in all patients who suffered from spontaneous ruptured hepatocellular adenoma. The mean age was 41.6 years old. The preoperative assessment included liver function tests, ultrasonography and computed tomography. RESULTS: The surgical approaches were as follows: right hemihepatectomy for controlling intraperitoneal bleeding, and right extended hepatectomy and non-anatomic resection of the liver for intrahepatic hemorrhage. There were no deaths, and the postoperative complications were bile leakage and wound infection (re-operation), as well as intraperitoneal abscess (re-operation) and pleural effusion. CONCLUSION: Spontaneous ruptured hepatocellular adenoma may be treated by surgery for controlling hemorrhages and stabilizing the patient, and the decision to operate depends upon both the patient's condition and the expertise of the surgical team.
publishDate 2009
dc.date.none.fl_str_mv 2009-01-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/clinics/article/view/17944
10.1590/S1807-59322009000800011
url https://www.revistas.usp.br/clinics/article/view/17944
identifier_str_mv 10.1590/S1807-59322009000800011
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/clinics/article/view/17944/20009
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
publisher.none.fl_str_mv Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
dc.source.none.fl_str_mv Clinics; Vol. 64 No. 8 (2009); 775-779
Clinics; v. 64 n. 8 (2009); 775-779
Clinics; Vol. 64 Núm. 8 (2009); 775-779
1980-5322
1807-5932
reponame:Clinics
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Clinics
collection Clinics
repository.name.fl_str_mv Clinics - Universidade de São Paulo (USP)
repository.mail.fl_str_mv ||clinics@hc.fm.usp.br
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