Not Sure What to Prefer When Facing Upcoming Rupture of Liver

Background: Bleeding under hepatic capsule resulting from spontaneous rupture of hepatocellular carcinoma (HCC) is an uncommon episode in clinical practice, which may lead to the potential of lethal consequence. However, the fact not sure what to prefer to conduct when facing upcoming rupture of the liver true capsule. Objective: Aims to identify the cause of tumor rupture and to judge the proper timing for surgery. Methods: We described a 53-year-old man, who was hospitalized with the misdiagnosis of acute cholecystitis and gallstone, which accurately was triggered by occult bleeding of a nodular regenerative hyperplasia under hepatic capsule closer to the gallbladder. He experienced a series of urgent rescue measures (cardiopulmonary cerebral resuscitation (CPCR), transcatheter arterial embolization (TAE) and laparotomy in turn). Results: Unfortunately, he died of liver failure, kidney failure, and cerebral hemorrhage. Conclusion: Herb may induce tumor necrosis or bleeding. The proper time for surgery and the optimized strategy, in this case, are of crucial importance to save one's life.