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Related Experiment Videos

Hepatoma presenting as lower gastrointestinal bleeding.

T M Singh Kalra, J C Mangla, S Schwartz

    The American Journal of Gastroenterology
    |May 1, 1977
    PubMed
    Summary

    A patient with alcoholic cirrhosis experienced severe rectal bleeding. Investigations revealed liver hepatoma with colon infiltration, leading to fatal hepatic coma.

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    Area of Science:

    • Hepatology
    • Gastroenterology
    • Oncology

    Background:

    • Alcoholic cirrhosis is a significant risk factor for liver diseases.
    • Hepatocellular carcinoma (HCC) can present with varied clinical manifestations.
    • Gastrointestinal bleeding is a serious complication in patients with advanced liver disease.

    Observation:

    • A 61-year-old male with known alcoholic cirrhosis presented with massive fresh rectal bleeding.
    • Initial investigations were inconclusive in determining the source of hemorrhage.
    • Selective hepatic and superior mesenteric angiography identified hepatoma of the liver.

    Findings:

    • The patient experienced recurrent massive lower gastrointestinal bleeding one month after initial presentation.
    • Autopsy revealed extensive hepatoma infiltrating the adjacent hepatic flexure of the colon.
    • The colonic infiltration by hepatoma was identified as the cause of the lower gastrointestinal hemorrhage.

    Implications:

    • This case highlights the importance of considering intra-abdominal malignancy in patients with cirrhosis and obscure gastrointestinal bleeding.
    • Angiography can be crucial in diagnosing occult liver and gastrointestinal pathologies.
    • Hepatoma infiltration into the colon can lead to severe gastrointestinal bleeding, underscoring the need for early detection and management.

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