Spontaneous rupture of giant hepatic hemangioma: misdiagnosis as gastrointestinal perforation

• Published in: Journal of international medical research Vol. 47; no. 9; pp. 4514 - 4521
• Main Authors: Zhai, Lu-Lu, Ju, Tong-Fa, Zhou, Chun-Hua, Xie, Qi
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.09.2019; Sage Publications Ltd; SAGE Publishing
• Subjects: Case Reports; Diagnostic Errors; Female; Hemangioma - diagnosis; Hemangioma - diagnostic imaging; Hemangioma - pathology; Humans; Intestinal Perforation - diagnosis; Intestinal Perforation - diagnostic imaging; Intestinal Perforation - pathology; Liver Neoplasms - diagnosis; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - pathology; Middle Aged; Rupture, Spontaneous - diagnosis; Rupture, Spontaneous - diagnostic imaging; Rupture, Spontaneous - pathology; Surgery; Tomography, X-Ray Computed; open surgery; hemoperitoneum; spontaneous rupture; peritonitis; laparoscopic surgery; Hepatic hemangioma
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060519866624

Hepatic hemangioma is a frequent nonmalignant tumor in the human liver. Although rupture of hepatic hemangioma is a rare complication, it may have serious consequences. In this report, we describe a 56-year-old woman who underwent laparoscopic surgery and open surgery for sudden abdominal pain and peritonitis. Gastrointestinal perforation was prioritized before surgery according to the patient’s symptoms, signs, and radiological report. A giant dark red mass connected to the left liver by a pedicle was unexpectedly found during intraoperative exploration. Hemoperitoneum was also found. Conversely, no gastrointestinal perforation was found during intraoperative exploration. The mass was successfully removed, and the hemoperitoneum was resolved. Postoperative pathological examination showed that the mass was a hepatic hemangioma. Ultimately, the patient was diagnosed with spontaneous rupture of a giant hepatic hemangioma.