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Spontaneously Ruptured Hepatocellular Carcinoma: Computed Tomography-Based Assessment

Spontaneously ruptured hepatocellular carcinoma (SRHCC) is an uncommon and life-threatening complication in patients with hepatocellular carcinoma (HCC). It is usually associated with chronic liver disease and has a poor prognosis with a high mortality rate during the acute phase. SRHCC can cause a...

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Autores principales: Sandomenico, Fabio, Arpaia, Valerio, De Rosa, Ferdinando, Catalano, Orlando, Buonaiuto, Roberto Antonino, Notarangelo, Marianna, Iovino, Maria, Giovine, Sabrina, Brunetti, Arturo, Scaglione, Mariano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10047024/
https://www.ncbi.nlm.nih.gov/pubmed/36980330
http://dx.doi.org/10.3390/diagnostics13061021
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author Sandomenico, Fabio
Arpaia, Valerio
De Rosa, Ferdinando
Catalano, Orlando
Buonaiuto, Roberto Antonino
Notarangelo, Marianna
Iovino, Maria
Giovine, Sabrina
Brunetti, Arturo
Scaglione, Mariano
author_facet Sandomenico, Fabio
Arpaia, Valerio
De Rosa, Ferdinando
Catalano, Orlando
Buonaiuto, Roberto Antonino
Notarangelo, Marianna
Iovino, Maria
Giovine, Sabrina
Brunetti, Arturo
Scaglione, Mariano
author_sort Sandomenico, Fabio
collection PubMed
description Spontaneously ruptured hepatocellular carcinoma (SRHCC) is an uncommon and life-threatening complication in patients with hepatocellular carcinoma (HCC). It is usually associated with chronic liver disease and has a poor prognosis with a high mortality rate during the acute phase. SRHCC can cause a severe and urgent condition of acute abdomen disease and requires a correct diagnosis to achieve adequate treatment. Clinical presentation is related to the presence of hemoperitoneum, and abdominal pain is the most common symptom (66–100% of cases). Although the treatment approach is not unique, trans-arterial (chemo)embolization (TAE/TACE) followed by staged hepatectomy has shown better results in long-term survival. A multi-phase contrast-enhanced CT (CECT) scan is a pivotal technique in the diagnosis of SRHCC due to its diagnostic accuracy and optimal temporal resolution. The correct interpretation of the main CT findings in SRHCC, such as active contrast extravasation and the sentinel clot sign, is fundamental for a prompt and correct diagnosis. Furthermore, CT also plays a role as a post-operative control procedure, especially in patients treated with TAE/TACE. Therefore, a multi-phase CECT scan should be the diagnostic tool of choice in SRHCC since it suggests an immediate need for treatment with a consequent improvement in prognosis.
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spelling pubmed-100470242023-03-29 Spontaneously Ruptured Hepatocellular Carcinoma: Computed Tomography-Based Assessment Sandomenico, Fabio Arpaia, Valerio De Rosa, Ferdinando Catalano, Orlando Buonaiuto, Roberto Antonino Notarangelo, Marianna Iovino, Maria Giovine, Sabrina Brunetti, Arturo Scaglione, Mariano Diagnostics (Basel) Review Spontaneously ruptured hepatocellular carcinoma (SRHCC) is an uncommon and life-threatening complication in patients with hepatocellular carcinoma (HCC). It is usually associated with chronic liver disease and has a poor prognosis with a high mortality rate during the acute phase. SRHCC can cause a severe and urgent condition of acute abdomen disease and requires a correct diagnosis to achieve adequate treatment. Clinical presentation is related to the presence of hemoperitoneum, and abdominal pain is the most common symptom (66–100% of cases). Although the treatment approach is not unique, trans-arterial (chemo)embolization (TAE/TACE) followed by staged hepatectomy has shown better results in long-term survival. A multi-phase contrast-enhanced CT (CECT) scan is a pivotal technique in the diagnosis of SRHCC due to its diagnostic accuracy and optimal temporal resolution. The correct interpretation of the main CT findings in SRHCC, such as active contrast extravasation and the sentinel clot sign, is fundamental for a prompt and correct diagnosis. Furthermore, CT also plays a role as a post-operative control procedure, especially in patients treated with TAE/TACE. Therefore, a multi-phase CECT scan should be the diagnostic tool of choice in SRHCC since it suggests an immediate need for treatment with a consequent improvement in prognosis. MDPI 2023-03-07 /pmc/articles/PMC10047024/ /pubmed/36980330 http://dx.doi.org/10.3390/diagnostics13061021 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Sandomenico, Fabio
Arpaia, Valerio
De Rosa, Ferdinando
Catalano, Orlando
Buonaiuto, Roberto Antonino
Notarangelo, Marianna
Iovino, Maria
Giovine, Sabrina
Brunetti, Arturo
Scaglione, Mariano
Spontaneously Ruptured Hepatocellular Carcinoma: Computed Tomography-Based Assessment
title Spontaneously Ruptured Hepatocellular Carcinoma: Computed Tomography-Based Assessment
title_full Spontaneously Ruptured Hepatocellular Carcinoma: Computed Tomography-Based Assessment
title_fullStr Spontaneously Ruptured Hepatocellular Carcinoma: Computed Tomography-Based Assessment
title_full_unstemmed Spontaneously Ruptured Hepatocellular Carcinoma: Computed Tomography-Based Assessment
title_short Spontaneously Ruptured Hepatocellular Carcinoma: Computed Tomography-Based Assessment
title_sort spontaneously ruptured hepatocellular carcinoma: computed tomography-based assessment
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10047024/
https://www.ncbi.nlm.nih.gov/pubmed/36980330
http://dx.doi.org/10.3390/diagnostics13061021
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