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Case report
peer-reviewed

Spontaneous Rupture of a Hepatic Adenoma: Diagnostic Nuances and the Necessity of Followup



Abstract

We present the case of a young female on oral contraceptives (OCs) who was diagnosed with focal nodular hyperplasia (FNH) and remained on oral contraceptives. Months later, the patient presented with acute abdominal pain and intratumoral hemorrhage in the liver. The patient was taken to the operating room (OR) and was diagnosed with a ruptured hepatic adenoma (HA). We review the key diagnostic features of FNH and HA, the different management guidelines including use of OCs, and potential surgical indications. HA compared to FNH has a significantly higher rate of sequelae despite being a benign lesion, thus providers must accurately distinguish between the two diagnoses to prevent potential morbidity and mortality.



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Case report
peer-reviewed

Spontaneous Rupture of a Hepatic Adenoma: Diagnostic Nuances and the Necessity of Followup


Author Information

Preston F. Ashby

Department of Surgery, Arizona College of Osteopathic Medicine

Chelsea Alfafara

College of Medicine, University of Arizona

Albert Amini

Arizona Premier Surgery, Chandler Regional Hospital

Richard Amini Corresponding Author

Department of Emergency Medicine, University of Arizona


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.


Case report
peer-reviewed

Spontaneous Rupture of a Hepatic Adenoma: Diagnostic Nuances and the Necessity of Followup


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Case report
peer-reviewed

Spontaneous Rupture of a Hepatic Adenoma: Diagnostic Nuances and the Necessity of Followup

  • Author Information
    Preston F. Ashby

    Department of Surgery, Arizona College of Osteopathic Medicine

    Chelsea Alfafara

    College of Medicine, University of Arizona

    Albert Amini

    Arizona Premier Surgery, Chandler Regional Hospital

    Richard Amini Corresponding Author

    Department of Emergency Medicine, University of Arizona


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements


    Article Information

    Published: December 20, 2017

    DOI

    10.7759/cureus.1975

    Cite this article as:

    Ashby P F, Alfafara C, Amini A, et al. (December 20, 2017) Spontaneous Rupture of a Hepatic Adenoma: Diagnostic Nuances and the Necessity of Followup. Cureus 9(12): e1975. doi:10.7759/cureus.1975

    Publication history

    Received by Cureus: October 18, 2017
    Peer review began: November 17, 2017
    Peer review concluded: December 15, 2017
    Published: December 20, 2017

    Copyright

    © Copyright 2017
    Ashby et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

We present the case of a young female on oral contraceptives (OCs) who was diagnosed with focal nodular hyperplasia (FNH) and remained on oral contraceptives. Months later, the patient presented with acute abdominal pain and intratumoral hemorrhage in the liver. The patient was taken to the operating room (OR) and was diagnosed with a ruptured hepatic adenoma (HA). We review the key diagnostic features of FNH and HA, the different management guidelines including use of OCs, and potential surgical indications. HA compared to FNH has a significantly higher rate of sequelae despite being a benign lesion, thus providers must accurately distinguish between the two diagnoses to prevent potential morbidity and mortality.



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Create a free account to continue reading this article.

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Preston F. Ashby

Department of Surgery, Arizona College of Osteopathic Medicine

Chelsea Alfafara

College of Medicine, University of Arizona

Albert Amini

Arizona Premier Surgery, Chandler Regional Hospital

Richard Amini, M.D., Associate Professor

Department of Emergency Medicine, University of Arizona

For correspondence:
richardamini@gmail.com

Preston F. Ashby

Department of Surgery, Arizona College of Osteopathic Medicine

Chelsea Alfafara

College of Medicine, University of Arizona

Albert Amini

Arizona Premier Surgery, Chandler Regional Hospital

Richard Amini, M.D., Associate Professor

Department of Emergency Medicine, University of Arizona

For correspondence:
richardamini@gmail.com