Spontaneous hemoperitoneum due to rupture of hepatocellular carcinoma.

Spontaneous rupture with hemoperitoneum is one of the atypical modes of presentation of hepatocellular carcinoma (HCC), common in the orient (8-14% cases) but reported only once from India. Another case is being reported here. Hemostasis can be achieved by transcatheter hepatic artery ligation, intralesional alcohol injection, microwave application, curettage with suturing or gauze packing. Resectional surgery, preferably at a second stage, has the best long term outcome. Prognosis remains poor with few long term survivors.