Spontaneous rupture of peritoneal seeding hepatocellular carcinoma: Report of two cases

Non-traumatic hemoperitoneum is a potentially life threatening condition that requires prompt diagnosis and intervention in the emergency department (ED). There are many causes of non-traumatic hemoperitoneum, but spontaneous rupture of a peritoneal seeding tumor is rare. We describe two cases of spontaneous rupture of a peritoneal seeding hepatocellular carcinoma (HCC), following spontaneous rupture of HCC in the ED. Two patients, with a history of ruptured HCC presented with acute left upper quadrant and right lower quadrant abdominal pain. Vital signs were stable, and the diagnosis was made by contrast-enhanced computed tomography scan of abdomen. The patients survived because of early diagnosis and surgical intervention. This report highlights that spontaneous rupture of peritoneal seeding HCC can occur after spontaneous rupture of HCC. Emergency physicians should be aware of this rare complication, particularly in Asian countries. Surgical intervention is the appropriate choice for definitive treatment.