Spontaneous rupture of giant hepatic hemangioma: a rare source of hemoperitoneum. Case report

Hemoperitoneum due to spontaneous rupture of a hepatic hemangioma is a rare and serious clinical event with a high mortality rate. 25-year-old woman under hormonal treatment for pregnancy with abdominal pain with distension followed by vomits, palpable epigastric mass and paleness of the skin and mucosas. Computed tomography of the abdomen without oral and venous contrast showed a heterogeneous and capsulated tumor of the liver. Exploratory laparotomy was carried out that revealed a large tumor occupying the gastro-hepatic site with partial rupture of the tumor's capsule with bleeding. Because of the close relationship between the tumor and the retro-hepatic inferior vena cava, the partial resection of the tumor was realized. The patient had a good post-operative evolution. The study of the tumor revealed hepatic hemangioma. Hepatic Hemangiomas may evolve to spontaneous rupture leading to hemorrhagic acute abdomen. Surgery is mandatory and the resection of the Hemangioma will depend on the clinical condition of the patient and on the relationship of the tumor with the vascular structures of the liver. Partial resection is a safe choice that saves lives in urgency situations, as the one described herein.