Resumo

STOCCO, Ricardo et al. Spontaneous liver hemorrhage due to occult liver adenomas. Gen [online]. 2025, vol.79, n.3, pp.138-143.  Epub 11-Jul-2025. ISSN 0016-3503.  https://doi.org/10.61155/gen.v79i3.724.

Spontaneous liver hemorrhage is a rare but potentially life-threatening condition that occurs in the absence of trauma. It constitutes a surgical emergency that, if not promptly addressed, may lead to intra-abdominal bleeding, hemorrhagic shock, or death. We report the case of a 42-year-old woman undergoing treatment for a respiratory viral infection (SARS-CoV-2), who was also receiving anticoagulant therapy. On the third day of treatment, she developed sudden right upper quadrant abdominal pain and a drop in hemoglobin levels, although she remained hemodynamically stable. A computed tomography (CT) scan revealed multiple hyperdense areas in both hepatic lobes and free fluid in the abdominal cavity, consistent with hemoperitoneum. She received two units of packed red blood cells and was transferred to our facility, where abdominal arteriography showed no evidence of active bleeding. During her hospital course, the patient remained stable, and hemoglobin levels remained steady. She was discharged in good condition. Follow-up imaging with CT confirmed the presence of a spontaneous hepatic hematoma. Six months later, a magnetic resonance imaging (MRI) scan with a liver-specific protocol revealed complete resorption of the hematoma and identified focal hepatic lesions consistent with hepatic adenomas. This case highlights our experience with the conservative management of spontaneous hepatic hematoma in a patient with benign focal liver lesions at high risk of hemorrhage, likely exacerbated by oral contraceptive use.

Palavras-chave : Hepatic adenoma; Spontaneous liver hemorrhage.

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