Minor Fall Leading to Fatal Rupture of Solitary Giant Sub-Capsular Cavernous Haemangioma of Liver: a Case Report

A Menon P, A Balachandran

77

Abstract

Background: The liver which is a vascular organ can easily be lacerated or crushed, depending on the severity of trauma.

Case Report: A 55 year-old lady who fell down was taken to a hospital within one hour and died two hours post-trauma. An autopsy revealed rupture a large sub capsular vascular lesion situated on the right lobe of liver with hemoperitoneum. There was a deep contusion on the abdominal wall adjacent to the costal margin on the right side, roughly overlying the rupture, but the skin showed no evidence of injury on external examination. Histopathology revealed that the lesion was a giant cavernous haemangioma of the liver which was undetected prior to the incident.

Conclusion: Certain conditions like fatty liver disease, polycystic disease and cavernous haemangioma can predispose liver injury, even with considerably less amount of force than is ordinarily required.

Keywords

Angioma Liver, Cavernous Haemangioma, Fall, Liver Laceration, Death

Full Text:

PDF

References

Beckingham IJ, Krige JE. ABC of diseases of liver, pancreas, and biliary system: Liver and pancreatic trauma. BMJ. 2001;322:783–5.

Di Maio VJ, Di Maio DJ, Forensic Pathology 2nd Edition CRC Press London 2001.

Atanasijevic TC, Savic SN, Nikolic SD, Djoki VM. Frequency and severity of injuries in correlation with the height of fall. J Forensic Sci. 2005;50(3):608-12.

Tong F, Liang Y, Zhang L, Li W, Chen P, Duan Y, et al. Fatal Liver Cyst Rupture in Polycystic Liver Disease Complicated with Autosomal Dominant Polycystic Kidney Disease: A Case Report, Forensic Science International (2016), http://dx.doi.org/10.1016/j.forsciint.2016.03.045

Lerner SM, Hiatt JR, Salamandra J, Chen PW, Farmer DG, Ghobrial RM, Busuttil RW Giant cavernous liver hemangiomas: effect of operative approach on outcome Arch Surg. 2004;139(8):818-21.

Schwartz SI, Husser WC. Cavernous hemangioma of the liver. A single institution report of 16 resections Ann Surg. 1987;205(5):456-65

Di Carlo I, Koshy R, Al Mudares S, Ardiri A, Bertino G, Toro A. Giant cavernous liver hemangiomas: is it the time to change the size categories? Hepatobiliary Pancreat Dis Int. 2016;15(1):21-9.

Karhunen PJ. Benign hepatic tumours and tumour like conditions in men. J Clin Pathol. 1986;39(2):183-8.

Gandolfi L, Leo P, Solmi L, Vitelli E, Verros G, Colecchia A. Natural history of hepatic haemangiomas: clinical and ultrasound study. Gut. 1991;32(6):677-80.

Gilon D, Slater PE, Benbassat J. Can decision analysis help in the management of giant hemangioma of the liver? J Clin Gastroenterol. 1991;13(3):255-8.

Meron G, Kurkciyan I, Sterz F, Susani M, Domanovits H, Tobler K, Bohdjalian A, Laggner AN Cardiopulmonary resuscitation-associated major liver injury. Resuscitation. 2007;75(3):445-53.

Jin, Wangxun et al. “Mechanisms of Blunt Liver Trauma Patterns: An Analysis of 53 Cases.” Experimental and Therapeutic Medicine. 2013;5(2):395–8.

Subedi N, Yadav BN, Jha S. Liver and Spleen Injuries and Associated Rib Fractures: An Autopsy Study. J Forensic Res. 2014;5:240.

Mays ET. Bursting injuries of the liver. A complex surgical challenge. Arch Surg. 1966; 93(1):92-106.

Tait N, Richardson AJ, Muguti G, Little JM. Hepatic cavernous haemangioma: a 10 year review. Aust N Z J Surg. 1992;62(7):521-4.