Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2020; 8(10): 2016-2022
Published online May 26, 2020. doi: 10.12998/wjcc.v8.i10.2016
Unexplained huge liver infarction presenting as a tumor with bleeding: A case report
Fu-Hai Wang, Ning-Ning Yang, Feng Liu, Hu Tian
Fu-Hai Wang, Feng Liu, Hu Tian, Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University, Jinan 250014, Shandong Province, China
Ning-Ning Yang, Department of Respiratory and Critical Care Medicine, Shandong Provincial Chest Hospital Affiliated to Shandong University, Jinan 250013, Shandong Province, China
Author contributions: Wang FH and Yang NN designed the report and wrote the paper; Wang FH, Liu F and Tian H performed the surgery; Yang NN collected the patient’s clinical data; Wang FH and Tian H analyzed the data and revised the paper; all authors have read and approved the final version of this manuscript; Wang FH and Yang NN contributed equally.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hu Tian, MD, PhD, Chief Doctor, Professor, Surgeon, Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University, No. 16766, Jingshi Road, Jinan 250014, Shandong Province, China. tianhu6585@163.com
Received: January 10, 2020
Peer-review started: January 10, 2020
First decision: March 18, 2020
Revised: March 26, 2020
Accepted: April 15, 2020
Article in press: April 15, 2020
Published online: May 26, 2020
Processing time: 136 Days and 8.2 Hours
Abstract
BACKGROUND

Liver infarction is a rare necrotic lesion due to the dual blood supply consisting of the hepatic artery and portal vein. The absence of specific clinical manifestations and imaging appearances usually leads to misdiagnosis and poor prognosis. Thus, the precise diagnosis of liver infarction always requires imaging studies, serum studies, and possible liver biopsy.

CASE SUMMARY

We report a case of 31-year-old man who developed a huge liver infarction. Persistent right upper abdominal pain and intermittent fever were the main symptoms in this patient. Computed tomography revealed a huge irregular lesion with a maximum diameter of 12.7 cm in the right lobe of the liver. Three-dimensional reconstruction was performed and no significant interruption of the main hepatic vessels was observed. The lesion was initially considered to be a malignant tumor with internal bleeding. Laparoscopic right hepatectomy was performed, and pathology indicated a rare liver infarction. The patient recovered well and was discharged on postoperative day 21. No fever or abnormal liver function were reported in the subsequent 6 mo.

CONCLUSION

In patients with a huge liver infarction, early surgical intervention may be beneficial.

Keywords: Liver infraction; Liver lesions; Surgery; Imaging; Diagnosis; Case report

Core tip: We report a case of liver infarction that was initially considered to be a tumor with bleeding based on computed tomography. Liver infarction is caused by the obstruction of hepatic vessels, and a huge liver infarction is very rare due to the dual hepatic blood supply. The clinical manifestations and imaging appearances of liver infarction are nonspecific. The precise diagnosis always requires multiple imaging methods, serum studies, and pathological examination. In addition to conservative treatment, early surgical intervention is beneficial in patients with a huge liver infarction. This case report provides a valuable reference for the diagnosis and treatment of this disease.