Use of radiofrequency ablation for controlling liver hemorrhage in the emergency setting; report of two cases and review of the literature.

Abstract

Active liver hemorrhage with hemodynamic instability is a serious situation often requiring surgical intervention. The most common causes of hepatic bleeding are trauma and tumors of the liver parenchyma: mainly hepatocellular carcinoma and adenoma. Liver hemorrhage from blunt trauma or spontaneous tumor rupture is sometimes difficult to control with traditional methods and postoperative complications are frequent. Recently, the radiofrequency ablation system (RF) has been used for obtaining haemostasis of ruptured hepatic tumors or for controlling hemorrhage due to liver trauma in experimental models. We report two cases where the radiofrequency ablation system (RF) has been efficiently used during emergency laparotomy in humans in order to control massive hemorrhage from spontaneous rupture of a liver metastatic testicular germ cell tumor and from a Grade IV blunt liver trauma. RF ablation system combined with traditional techniques was effective in controlling liver bleeding during laparotomy in both cases. No recurrence of the hemorrhage or any side effects associated with the RF system were recorded postoperatively. RF system is an effective strategy for achieving hemostasis in patients with active liver hemorrhage. In cases of bleeding liver tumors, RFA could also be helpful in synchronous tumor elimination, maximizing the chances of longer term survival.

• Authors: Ioannis Maroulis, Charalambos Spyropoulos, Christina Kalogeropoulou, Dimitrios Karavias
• Journal: Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES (Ulus Travma Acil Cerrahi Derg) Vol. 19 Issue 2 Pg. 167-72 (Mar 2013) ISSN: 1306-696X [Print] Turkey
• PMID: 23599203 (Publication Type: Case Reports, Journal Article, Review)

Topics

• Ablation Techniques (methods)
• Adult
• Emergency Service, Hospital
• Hemorrhage (diagnostic imaging, surgery)
• Humans
• Liver Diseases (diagnostic imaging, surgery)
• Male
• Tomography, X-Ray Computed