Chaftik Kacem, MD; Kamel Helali, MD; Francois Puisieux, MD
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Kacem C, Helali K, Puisieux F. Recurrent Spontaneous Hepatic Rupture in Primary Hepatic Amyloidosis. Ann Intern Med. 1998;129:339. doi: 10.7326/0003-4819-129-4-199808150-00029
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Published: Ann Intern Med. 1998;129(4):339.
TO THE EDITOR:
We describe a 46-year-old woman who presented with a 2-year history of abdominal discomfort with recurrent extremity ecchymosis and 3 days of increased pain. Upon examination, her abdomen was distended with generalized guarding. Emergency laparotomy revealed hepatomegaly and a massive hemoperitoneum (1500 mL) caused be a partially ruptured subcapsular hematoma (diameter, 15 cm) involving the upper face of the left side of the liver. The hematoma was evacuated, and hemostasis was achieved with local coagulation. Surgical liver biopsy showed portal tracts containing intense amorphous infiltration of hyaline material confirmed to be amyloid by Congo red staining. Immunohistochemical studies yielded negative results. Coagulation studies revealed no coagulation defect. A complete evaluation showed no evidence of an underlying chronic disease. The patient was discharged 2 weeks after surgery with a diagnosis of primary hepatic amyloidosis and was being treated by colchicine.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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