INTRAPERITONEAL HEMORRHAGE DUE TO SPONTAN EOUS RUPTURE OF HEPATOCELLULAR-CARCINOMA - TREATMENT BY EMERGENCY EMBOLIZATION AND CHEMOEMBOLIZATION

Twelve caucasian patients with intraperitoneal hemorrhage due to spont aneous rupture of hepatocellular carcinoma were treated by emergency t ranscatheter arterial embolization (n = 9) or chemoembolization (n = 3 ). Pretreatment angiography showed active bleeding (extravasation of c ontrast medium) in two patients only. Successful hemostasis was initia lly achieved in all patients. Early recurrence of hemorrhage was noted in 3 patients with large tumors; two were successfully treated by a s econd embolization and one died immediately after the first embolizati on. Of the 12 patients, two underwent subsequent chemoembolization whi le two had surgical resection of their tumors. The mean length of surv ival was 7 months from the time of rupture. No serious complications r elated to embolization or chemoembolization were noted. Our data sugge st that emergency embolization or chemoembolization is an effective tr eatment in caucasian patients with intraperitoneal hemorrhage from hep atocellular carcinoma. Prognosis of ruptured hepatocellular carcinoma in those patients, however, remains poor.