Hepatic hemangiomas and parachuting

Hepatic hemangiomas are relatively common benign hepatic tumors. Historically, a concern for potential traumatic rupture has influenced clinical judgment regarding optimal treatment. However, a review of the literature fails to demonstrate spontaneous or traumatic rupture as a common phenomenon. The following case report discusses an individual patient incidentally found to have large hepatic hemangiomas on CT scan during work-up for a traumatic minimally displaced pelvic fracture from parachuting. He was admitted to the general surgery service for observation. After several days of hemodynamic stability and pain control, he was released to home with outpatient physical therapy and follow-up with the orthopedic surgery clinic. Interventional radiology was also consulted regarding his fitness to continue parachuting given his large hepatic hemangiomas. Embolization was not recommended, but rather continued observation without any restriction of physical activities. Review of the literature supports an extremely low incidence of traumatic rupture. Consequently, a hepatic hemangioma should not exclude an individual from parachuting.