During the period from January 1970 to December 1975, 12 patients with primary carcinoma of the liver and intraperitoneal hemorrhage were surgically treated at this hospital.
I. During the same period, 67 patients were surgically diagnosed as primary carcinoma of the liver and the incidence of intraperitoneal hemorrhage was. 17.9%.
2. Male predominated female with the ratio of 10:2, and 7´patients were in 5th decade.
3. Chief complaint was upper or right upper quadrant abdominal pain in 7 patients and the duration of symptoms were relatively short, less than 1 month in 8 patients.
4. Since several months prior to admission, patients noted weight loss (7 patients) and indi-gestion (6 patients).
5. There were no specific physical findings or laboratory data except elevated alkaline phosphates, reversal of albumin/globulin ratio and low hematocrit (6,7 & 8 patients respectively).
6. The tumors were located in both lobes of the liver in 8 patients and localized in one lobe in 4 patients.
7. In 9 out of 12 patients, cirrhotic nodules were identified on operation. Histological diag-nosis were made in 9 patients as hepatocellular carcinoma and there was no cholangiocellular carcinoma.
8. Curative resection was carried out in only one patient. Palliative measures were applied in others.
9. Post-operative course were improved in one patient, uneventful in 5 patients, aggravated in 5 patients and one patient died on the 3 rd post-operative day.
10. In conclusion, intraperitoneal hemorrhage is one of the fatal complications of the primary carcinoma of the liver which can occur spontaneously in the natural course of this disease. Therefore, one must always bear in mind its occurrence whenever dealing with suspected carcinoma of the liver. At present, early diagnosis and curative resection is the only effective method of treatment and can offer prolongation of survival time.
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