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Case Reports in Hepatology
Volume 2016, Article ID 7082387, 4 pages
Case Report

Severe Anemia with Hemoperitoneum as a First Presentation for Multinodular Hepatocellular Carcinoma: A Rare Event in Western Countries

1Department of Internal Medicine, Interfaith Medical Center, Brooklyn, NY, USA
2Department of Pathology, Interfaith Medical Center, Brooklyn, NY, USA
3Division of Oncology, Interfaith Medical Center, Brooklyn, NY, USA

Received 12 August 2016; Revised 2 November 2016; Accepted 10 November 2016

Academic Editor: Tawesak Tanwandee

Copyright © 2016 Thein Swe et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Hemoperitoneum due to spontaneous rupture of hepatocellular carcinoma is a life-threatening and rare condition in western countries with an incidence of less than 3% because of early detection of cirrhosis and neoplasm. Here, we describe a case of a 66-year-old male patient with altered mental status with hemorrhagic shock. Computed tomography scan of abdomen revealed hemoperitoneum and mass in liver. Patient underwent resection of liver tumor and biopsy revealed multinodular hepatocellular carcinoma. A high degree of suspicion is required where severe anemia and hemoperitoneum can be a first presentation for hepatocellular carcinoma especially in patients with chronic hepatitis C infection. Early diagnosis is crucial since mortality rates remain high for untreated cases.