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. 2001 Feb;88(2):207-9.
doi: 10.1046/j.1365-2168.2001.01648.x.

Treatment of ruptured hepatocellular adenoma

T Terkivatan  1 , J H de Wilt, R A de Man, R R van Rijn, H W Tilanus, J N IJzermans
Affiliations

Treatment of ruptured hepatocellular adenoma

T Terkivatan et al. Br J Surg. 2001 Feb.

Abstract

Background: As the morbidity and mortality rates associated with emergency resection in patients with a ruptured hepatocellular adenoma are high, the authors have favoured initial non-operative management in haemodynamically stable patients.

Methods: A retrospective study was performed to evaluate the treatment of ruptured hepatocellular adenoma.

Results: Over a 21-year interval, 12 patients presented with a ruptured hepatocellular adenoma. Haemodynamic observation and support was the initial management in all 12 patients. Three underwent urgent laparotomy and gauze packing because of haemodynamic instability; no emergency liver resection was necessary. Eight patients had definitive surgery; three developed postoperative complications but none died. Regression of the tumour was observed in three of four patients treated conservatively.

Conclusion: The initial management of a ruptured hepatocellular adenoma should be haemodynamic stabilization. Definitive resection is required for rebleeding or for tumours exceeding 5 cm in diameter. A conservative approach may well be justified in case of regression of an asymptomatic adenoma.

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