Focal nodular hyperplasia of the liver: report of six patients. Concepts of surgical management.

The authors add six patients with focal nodular hyperplasia of the liver to the increasing number reported. All had ingested hormones as contraceptives for periods of from one and one-half to seven years. In five patients, the initial manifestation was massive intraabdominal hemorrhage and hypovolemic shock. Five of the six underwent emergency laparotomy for control of hemorrhage. Five patients are living; one patient died six days postoperatively because of coagulopathy. The single diagnostic procedure which proved valuable was liver scan. When hepatic focal nodular hyperplasia is disclosed, we recommend limited resection without ligation of the hepatic artery. Ingestion of birth control hormones should be prohibited.