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Acute haemoperitoneum due to small bowel metastases from hepatocellular carcinoma in a long term survivor following previous rupture
Ann Hepatobiliary Pancreat Surg 2018 Nov;22(4):416-8
Published online November 30, 2018
Copyright © 2018 Ann Hepatobiliary Pancreat Surg.

Vishal G Shelat1, Danilo Medina Giron2, Aung Myint Oo1

1Department of General Surgery, Tan Tock Seng Hospital, 2Department of Pathology, Tan Tock Seng Hospital, Singapore
Received February 18, 2018; Revised September 1, 2018; Accepted September 3, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
We report a 75-year old patient, presenting with acute abdomen and hemorrhagic shock. He provided history of right hemihepatectomy performed 5 years ago, for ruptured hepatocellular carcinoma on a background of Hepatitis B virus associated liver cirrhosis. A computerized tomography scan showed 5 cm-sized mass exophytic lesion, in the small bowel with haemoperitoneum. An emergency laparotomy and small bowel resection, with primary anastomosis was performed. Histology showed Hep Par 1 stain reactive cells, on the serosal surface of the small bowel. A final diagnosis of metastatic hepatocellular carcinoma was made.
Keywords : Haemoperitoneum; Hepatocellular carcinoma; Metastasis; Rupture


November 2018, 22 (4)