Management and Outcomes of Spontaneous Rupture of Hepatocellular Carcinoma: Current Practice

Objectives: To review the current management options for ruptured hepatocellular carcinoma (HCC) at acute presentation and assess the impact of each treatment modality on short- and long-term patient related outcome. Study design: A PubMed search was undertaken for review articles from 1950 to 2019 using key phrases “Ruptured hepatocellular carcinoma”, “trans-arterial embolization”, “resection”, “computed tomographic scan” and “conservative management”. Further manual search was performed to identify key articles from the reference list. Methodology: All papers with previous described management for ruptured HCC were reviewed. The morbidity, mortality and comparison of various management options were reviewed. Current practice guidelines were visited to identify common practice protocols. Conclusion: Ruptured HCC is associated with significant morbidity and mortality. Multiple management options can be applied guiding by patient’s overall condition. Conservative management is associated with overall poor outcome. Staged liver resection is associated with better outcome with improved morbidity and mortality.