Spontaneous rupture of a giant liver hemangioma

Introduction: Liver hemangiomas are the most prevalent benign hepatic tumors, which are frequently found incidentally when imaging for other conditions. They typically do not have any symptoms and do not require treatment. However, spontaneous rupture is an uncommon but potentially deadly consequence that mostly affects large hemangiomas. The patient described in this case study had anemia and abdominal discomfort. He was diagnosed by computed tomography (CT) and managed successfully by transarterial embolization. Case Report: We report on an 80-year-old man who was blind, known to have hypertension, old stroke, epilepsy, recurrent lower limb deep-vein thrombosis. He was on multiple medications for forementioned conditions and on oral anticoagulants. He presented to our emergency department with vomiting and abdominal discomfort for a few days. There was low hemoglobin (6.26 g/dL), increased lactate (9.17 mmol/L), low blood pressure (90/40 mmHg) and heart rate (80/min) at admission. A heterogenous low echoic liver mass and intra-abdominal free fluid was seen on bedside sonography. An intra-abdominal hemorrhage and a ruptured liver hemangioma with subcapsular hematoma were discovered by CT. After a CT scan, the patient experienced tachycardia with a heart rate (HR) of 150 beats per minute. Urgent transarterial embolization was done after stabilization. The patient was admitted under observation for 12 days following intervention and then discharged. Conclusion: Spontaneously ruptured hepatic hemangiomas are quite uncommon which can be easily diagnosed by CT. Transarterial embolization may be an alternative management to surgery in certain instances of atraumatic, ruptured hepatic hemangiomas.