Successful Management of Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock Due to Ruptured Hepatocellular Carcinoma

Intern Med. 2022 Apr 15;61(8):1157-1162. doi: 10.2169/internalmedicine.8133-21. Epub 2021 Sep 25.

Abstract

A 68-year-old man was transferred to our hospital because of sudden right costal pain with unmeasurable hypotension. Ultrasonography revealed possible hemorrhagic shock due to ruptured hepatocellular carcinoma (HCC). As the patient was not hemodynamically stable after primary treatment, resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed, and hemodynamic stability was then achieved. Contrast-enhanced computed tomography confirmed the diagnosis. Transcatheter artery embolization with gelatin sponge particles and coils eliminated the extravasation. The patient was discharged on day 36 post-procedure. Our observations suggest that REBOA may help achieve hemodynamic stability in cases of ruptured HCC.

Keywords: hepatocellular carcinoma; resuscitative endovascular balloon occlusion of the aorta; transcatheter arterial embolization.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aorta / diagnostic imaging
  • Balloon Occlusion* / methods
  • Carcinoma, Hepatocellular* / complications
  • Carcinoma, Hepatocellular* / therapy
  • Endovascular Procedures* / methods
  • Humans
  • Liver Neoplasms* / complications
  • Liver Neoplasms* / therapy
  • Male
  • Shock, Hemorrhagic* / complications
  • Shock, Hemorrhagic* / therapy