Spontaneous rupture of a hepatic epithelioid angiomyolipoma: damage control surgery. A case report

Occhionorelli, Savino and Dellachiesa, Laura and Stano, Rocco and Cappellari, L. and Tartarini, D. and Severi, S. and Palini, G.M. and Pansini, Gian Carlo and Vasquez, Giorgio (2013) Spontaneous rupture of a hepatic epithelioid angiomyolipoma: damage control surgery. A case report. Il giornale di chirurgia, 34 (11/12). pp. 320-322. ISSN 1971-145X

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Abstract

Background Angiomyolipoma (AML) is a rare mesenchymal tumor composed by blood vessels, adipose tissue and smooth muscle cells in variable proportions. Although it is most often diagnosed in the kidney, this tumor may originate from any part of the liver. It is often misdiagnosed as hepatocellular carcinoma (HCC) or other benign liver tumor. We describe a case of spontaneous rupture of hepatic angiomyolipoma in a young woman, with evidence of internal hemorrhage and hemoperitoneum. Case report Liver tumor rupture is a rare but real surgical emergency. In our case it has been managed according to the trauma principles of the damage control surgery. At the time of the observation, the patient presented an instable condition, so the decision-making was oriented toward a less invasive first step of liver packing instead of a more aggressive intervention such as one shot hepatic resection. Conclusion Damage control surgery with deep parenchymal sutures of the liver and pro-coagulant tissue adhesives packing abbreviates surgical time before the development of critical and irreversible physiological endpoints and permits a more confident second time surgery. This surgical management concept helps to reduce the mortality rate and the incidence of complications not only in traumatic liver damages, it works very well in spontaneous liver ruptures as well.

Item Type:	Article
Uncontrolled Keywords:	Angiomyolipoma, Damage control surgery, Liver lobectomy
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User:	Nadia Del Gobbo
Date Deposited:	13 Sep 2019 13:29
Last Modified:	13 Sep 2019 13:29
URI:	http://eprints.bice.rm.cnr.it/id/eprint/8669

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