How to treat ruptured and bleeding liver cancer

Rupture and bleeding of primary liver cancer is one of the serious complications of liver cancer and the main cause of death in liver cancer patients. According to literature statistics, the incidence of spontaneous rupture and bleeding of primary liver cancer is 12%~14.5% in high-incidence areas of liver cancer in Asia and Africa. The misdiagnosis rate of rupture and bleeding of primary liver cancer is as high as 50%. About 10% of liver cancer patients die from rupture and bleeding of liver cancer. It is more common in massive and nodular liver cancers located on the surface of the liver, and rupture and bleeding are rare in diffuse liver cancers.

Clinical manifestations can be divided into several situations

1. The general manifestations of liver cancer include hepatomegaly, weight loss, low fever, jaundice, elevated serum AFP, etc. Some patients have been clearly diagnosed and are receiving treatment before liver cancer ruptures and bleeds, while some patients have rupture and bleeding as the first symptom.

2. Acute peritonitis is characterized by severe abdominal pain that cannot be touched and tense abdominal muscles, which are usually more obvious in the right upper abdomen. It may be accompanied by abdominal distension, nausea, and vomiting. Abdominal examination may reveal mobile dullness, etc.

3. Symptoms of bleeding include pale complexion, cold sweat, dizziness, palpitations, rapid pulse, cold limbs, and low blood pressure.

There are 6 common reasons for misdiagnosis:

1. Lack of understanding of liver cancer rupture and bleeding and insufficient clinical experience.

2. Lack of typical clinical manifestations. No liver cancer was found before rupture, and no obvious symptoms occurred after rupture and bleeding.

3. Patients with chronic hepatitis and cirrhosis are not vigilant enough about liver cancer rupture and bleeding.

4. If abdominal pain is the first symptom of liver cancer rupture, analyze the pain and accompanying symptoms.

5. Failure to perform diagnostic abdominal puncture in a timely manner.

6. Insufficient analysis of the causes of internal bleeding.