BACKGROUND: Spontaneous rupture is a life-threatening complication of HCC, occurring in 4.8-26% of cases. @entity1578 is the main cause of @entity204 . Debates still remain on the most appropriate treatment in such @entity1 because of the high operative mortality of emergency surgery and the high risk of rebleeding and less satisfying mid- and long-term results of nonoperative procedures like angiographic embolization. Early and long-term results of a surgically oriented treatment, based on prompt evaluation of the functional liver reserve and @entity5 resectability was retrospectively review-ed. METHODS: From January 1994 to December 2000, 11 @entity1 (7 males and 4 female, mean age 66.2 (11.86 years) were treated for @entity397 , in 10 cases involving a cirrhotic liver. Seven @entity1 underwent emergency surgery and 4 @entity1 transcutaneous @entity1416 (TAE). Liver resection was performed in @entity1 with preserved liver function, after ultrasonography and/or CT scan demonstrated hemoperitoneum and a single resectable @entity96 (5 cases). In one @entity1 with @entity82 , ultrasonography showed only hemoperitoneum. A @entity548 nodule was discovered intraoperatively and resected in a liver with a multinodular HCC. Another @entity1 under-went emergency resection after referral at our Unit with a surgical packing. In 4 cases with poor liver function and/or unresectable @entity5 TAE of the @entity5 was performed, in one case after surgical packing. Mortality, morbidity and @entity1 survival after treatment were analyzed. All @entity1 had at least 1 year follow-up. RESULTS: All @entity1 underwent minor resection; 2 left lobectomies, 1 segmentectomy (VII), 1 bisegmentectomy (VII- @entity797 ), and 3 wedge resections. Postoperative course was complicated by ascites in 5 cases and @entity3117 in one case. Four @entity1 died 3, 4, 6 and 62 months after surgery; 3 @entity1 are actually alive 22, 25, and 89 months after surgery. Four @entity1 were submitted to TAE: all @entity1 died within 6 months. CONCLUSIONS: When @entity397 is suspected, preserved liver function ( @entity1 A-B7) and a resectable @entity5 are considered clear indications to surgery. Emergency liver resection achieved good early and long-term results. In cases of advanced @entity409 or multinodular HCC a non-operative approach, like TAE, must be attempted. Surgical direct hemostasis or hepatic artery ligation must be reserved for @entity1 with uncontrollable o recurrent @entity548 after TAE.

Management of spontaneous XXXX due to hepatocellular carcinoma.

@entity1 :: ('9606', 'Species') :: ['Child', 'patients', 'patient'] @entity82 :: ('MESH:D005355', 'Disease') :: ['cirrhosis'] @entity3117 :: ('MESH:D013369', 'Disease') :: ['subphrenic abscess'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity96 :: ('MESH:D008113', 'Disease') :: ['liver tumour'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'hepatic tumour', 'neoplasm', 'tumour'] @entity409 :: ('MESH:D008107', 'Disease') :: ['liver disease'] @entity1416 :: ('MESH:D020762', 'Disease') :: ['arterial embolization'] @entity797 :: ('1351', 'Gene') :: ['VIII'] @entity1578 :: ('MESH:D017093', 'Disease') :: ['Liver failure'] @entity397 :: ('MESH:D012421', 'Disease') :: ['ruptured HCC'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity548 :: (MESH:D006470,Disease) :: ['bleeding']
