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Case Rep Gastroenterol. 2017 Mar 21;11(1):155-161. doi: 10.1159/000463378. eCollection 2017 Jan-Apr.

Acute Abdomen: A Rare Case of Ruptured Hepatocellular Carcinoma.

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aDepartment of Visceral and Thoracic Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland.
bDepartment of Surgery and Orthopedics, Cantonal Hospital Schaffhausen, Schaffhausen, Switzerland.
cDivision of Trauma Surgery, University Hospital Zurich, Zurich, Switzerland.
dInstitute of Radiology and Nuclear Medicine, Cantonal Hospital Winterthur, Winterthur, Switzerland.
eDepartment of Visceral Surgery and Medicine, Inselspital, University of Bern, Bern, Switzerland.
fDepartment of Surgery, Spital Linth, Uznach, Switzerland.


Spontaneous ruptures of hepatocellular carcinoma (HCC) are rare. Nevertheless they may lead to difficult decisions in the emergency situation. The acute therapies include conservative treatment, transarterial embolization and surgery. Curative treatment of HCC can be achieved by liver resection solely. The decision-making depends on prognostic patient's factors, such as hepatic viral infection status, Child-Pugh grade, liver cirrhosis and number of tumors. In this case transarterial embolization was preferable as a bridging therapy prior to further diagnostics and therapy, to lower the perioperative morbidity and mortality. The therapy of these cases needs an interdisciplinary approach to choose the best possible procedure in each case.


Hepatocellular carcinoma; Operative treatment; Spontaneous rupture; Transarterial embolization

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