Spontaneous and traumatic rupture of hepatoma

Hepatoma is a common cause of spontaneous rupture of the liver. During recent years, spontaneous rupture was found in 11 (7 per cent) of 157 patients with hepatoma. The rupture occurred spontaneously in 7 patients, traumatically in 1 while in 3 patients trivial trauma seemed to be the precipitating factor. A correct preoperative diagnosis was made in 7 patients, all of whom were known to have a hepatoma. Hepatic resection was performed in 4 patients, 2 of whom were long term survivors. Haemorrhage stopped in 2 of 3 patients who underwent hepatic artery ligation, but only 1 patient was discharged from hospital. The remaining patients, who were treated by packing, suture or laparotomy alone, died within a short time after admission. It is suggested that resection is the preferred management, but if this is not possible hepatic artery ligation should be performed.