Treatment of Liver Cell Adenoma in Ruptured Hepatic Adenoma with Hemodynamic Instability
Spontaneous rupture of hepatic cell adenoma (HCA) is a recognised complication driven by the rich vascularity of this lesion. When rupture produces hemodynamic instability, it demands emergent clinical attention and a structured, staged management approach.
Clinical scenario
Ruptured hepatic adenoma with hemodynamic instability. The significant vascularity of HCAs makes spontaneous rupture a known risk, and hemodynamic compromise in this setting constitutes an urgent condition requiring immediate intervention.
Management approach
Evidence-based management prioritises hemodynamic stabilisation as the first step. For patients who are surgical candidates, the structured protocol addresses definitive management of the residual lesion through a surgical approach to reduce the risk of future recurrent hemorrhage. The full intervention sequence, candidacy criteria, and procedural details are available in the complete protocol.
References
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 the patient is a surgical candidate, residual HCA should be laparoscopically resected, minimizing risk of future recurrent hemorrhage.
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