Atraumatic Ruptured Giant (5Kg) Papillary Renal Cell Carcinoma: Emergency Laparotomy

Gezahen Ayane, Khutsafalo Kadimo
University of Botswana
Correspondence to: Dr. Gezahen Ayane, Private Bag 00713, Gaborone, Botswana; Email: Medpeter2003@yahoo.fr.

Summary

Background: Massive haemoperitoneum due to spontaneous rupture of Renal cell carcinoma is a rare presentation during emergency laparotomy. Case report: A 60-year-old female patient presented with severe abdominal pain, nausea, vomitus and abdominal distension which started about twelve hours prior to the examination. While she denied any abdominal trauma, her abdominal examination revealed peritoneal signs including increasing abdominal distension and abdominal tenderness. Her vitals were suggestive of hypovolemic shock; blood pressure 95/50 Torr; pulse: 115 per minute with oligo‐anuria. Fast abdominal ultrasound showed: a massive intra-abdominal free fluid plus a huge complex mass in the left hemiabdomen. The right kidney was normal and the left kidney was not visualized. After extensive resuscitation, the patient was taken for emergency exploratory laparotomy, where a massive Haemoperitoneum secondary to ruptured left kidney tumor was found. The post left nephrectomy histology report confirmed a ruptured left papillary renal cell carcinoma. Conclusion: Ruptured renal cell carcinoma can be secondary to abdominal trauma or can be spontaneous,without any physical evidence of abdominal trauma. The collection of blood is usually into the retroperitoneum space and may extend into the intraperitoneal cavity depending on the size of the tumor and the amount of bleeding.
Key words: Renal cell carcinoma, Rupture, Haemoperitoneum, Laparotomy, Complex mass, Nephrectomy, Papillary.

Ann Afr Surg. 2019; 17(1):***

DOI: http://dx.doi.org/10.4314/aas.v16i1.*

Conflicts of Interest: None

Funding: None

© 2020 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.

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