Massive haemoperitoneum complicating metastasis in the liver

The rare phenomenon of gross intra-abdominal bleeding due to hepatic metastasis was seen in a young male who a short time before had undergone orchiectomy because of embryonal cell carcinoma. Following laparotomy, 4 liters of fresh blood were drained from the peritoneal cavity and the left lobe of the liver, containing a single large metastasis, was removed. It is stressed that when no other cause of such haemorrhage can be found in a patient known to have had malignancy, the possibility of bleeding from a metastasis should be considered and appropriate measures taken.