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A 59-year-old chronic drinker (120 g alcohol/day) was hospitalized for sudden increase in abdominal volume found to be caused by a hemoperitonoff resulting from ruptured hepatocellular carcinoma with thrombosis of the portal vein. Emergency arterial embolization with gelatin sponge successfully stopped intraperitoneal bleeding. No surgical treatment could be attempted due the severity of the cirrhosis. This patient survived for 4.5 month. Based on this observation and a review of the literature, it can be suggested that hemostatic embolization is an effective treatment for spontaneous hemorrhage of hepatocellular carcinoma even in cases with portal vein thrombosis.
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