CENTRAL NECESSITY HEPATECTOMY FOR SPONTANEOUS RUPTURE OF HEPATOCELLULAR CARCINOMA AT A PATIENT WITH PORTAL BIFURCATION THROMBOSIS

A. Istodor; R. Ilina; M. Preda; O. Ardelean; O. Mazilu

doi:10.33695/jss.v6i4.290

A. Istodor 1First Department of Surgery, Second Discipline of Surgical Semiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania & 2Department of General Surgery and Surgical Oncology, Emergency City Hospital, Timisoara, Romania
R. Ilina 1First Department of Surgery, Second Discipline of Surgical Semiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania & 2Department of General Surgery and Surgical Oncology, Emergency City Hospital, Timisoara, Romania
M. Preda 1First Department of Surgery, Second Discipline of Surgical Semiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania & 2Department of General Surgery and Surgical Oncology, Emergency City Hospital, Timisoara, Romania
O. Ardelean 1First Department of Surgery, Second Discipline of Surgical Semiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania & 2Department of General Surgery and Surgical Oncology, Emergency City Hospital, Timisoara, Romania
O. Mazilu 1First Department of Surgery, Second Discipline of Surgical Semiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania & 2Department of General Surgery and Surgical Oncology, Emergency City Hospital, Timisoara, Romania

DOI: https://doi.org/10.33695/jss.v6i4.290

Keywords: hepatocellular carcinoma, ruptured liver tumor, portal thrombosis, hemoperitoneum, central hepatectomy

Abstract

Hepatocellular carcinoma (HCC), one of the commonest primitive malignant tumors of the liver, is currently considered one of the very high life-threatening tumors. Surgery remains the treatment of choice of HCC and is indicated whenever possible. We present the case of a patient 66 years old , at which abdominal CT scan reveals the presence of HCC in segments 4 and 8, broken, and perisplenic and perihepatic fluid accumulation in the context of declining hemoglobin. Associate there is an incomplete picture of the portal convergence of 1.9 cm, with the lack of visualization of the left portal wreath. Even in the absence of the possibility of curative resection due to spontaneous rupture of the liver tumor, it is made a central necessity hepatectomy and subsegmentectomy 2 and 3 for the other three formations located at this level. Patient's postoperative course was favorable and he was discharged 11 days after surgery. Abdominal MRI performed 2 months postoperatively revealed the presence of multifocal recurrence. Patient dies at 6 months postoperatively.