SUCCESSFUL LEFT TRISEGMENTECTOMY FOR RUPTURED HEPATOBLASTOMA USING INTRAOPERATIVE TRANSARTERIAL EMBOLIZATION

Although surgical treatment with resection for spontaneous rupture of hepatoblastoma into the free abdominal cavity is difficult in small ch ildren, it may be the only treatment available. The authors describe a 16-month-old girl who showed a progressive decrease in hematocrit and no response to blood transfusion, after spontaneous rupture of a larg e hepatoblastoma that extended to the pubic bone. Percutaneous transca theter arterial embolization could not be performed because selective catheterization was impossible. Therefore, emergency surgery was condu cted. After intraoperative transcatheter arterial embolization (IOTAE) to control hemorrhage, left trisegmentectomy was performed. The patie nt then underwent chemotherapy, followed by autologous bone marrow tra nsplantation. The hemorrhage from the ruptured tumor was completely ar rested by IOTAE, and the postoperative course was uneventful. Hepatic resection after IOTAE, followed by chemotherapy and bone marrow transp lantation, represents a promising treatment for ruptured hepatoblastom a. (C) 1995 by W.B. Saunders Company