Liver cell adenoma (hepatocellular adenoma, HCA) carries a known risk of spontaneous rupture owing to the rich vascularity of the lesion. When rupture occurs and the patient presents with hemodynamic instability, the situation requires emergent clinical attention and a structured, time-sensitive response.
Ruptured hepatic adenoma with hemodynamic instability. Spontaneous rupture of hepatocellular adenomas is a recognised complication that demands urgent intervention when haemodynamic compromise is present.
The emergent approach involves an endovascular embolization procedure directed at achieving haemodynamic stability. The complete protocol defines the precise indications, the criteria for escalation, and the pathway to definitive management.
DOI: 10.14309/ajg.0000000000002857
Because of the rich vascularity of this lesion, spontaneous rupture of HCAs is a known complication that requires emergent attention in the case of hemodynamic instability.
In patients with ruptured hepatic adenomas, we suggest hemodynamic stabilization followed by embolization and/or surgical resection (conditional recommendation, very low level of evidence).
If instability remains, emergent transarterial embolization (TAE) should be pursued to achieve hemodynamic stability until surgical resection can be performed.
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