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EN
The case reports about a 75-years-old man without a previous medical history, in whom a heart failure NYHA III de novo was diagnosed together with persistent atrial fibrillation and hepatocellular carcinoma in clinical stage IV. Based on echocardiography and computed tomography there were pulmonary hypertension in course of lymphangiosis carcinomatosa as well as diffuse metastases in the abdomen diagnosed. Before the treatment initiation the patient was classified 3 in WHO performance status. After an improvement in control of the rhythm frequency and the heart failure treatment stabilisation with a β-blocker, an ACE-inhibitor, spironolactone and furosemide, the patient’s performance status improved to WHO 2. He was further disqualified from surgical procedures due to the advanced clinical stage of the oncological disease. Considering high probability of further cardiotoxic influence of sorafenib on the heart failure despite its satisfactory control, the patient was assigned to palliative chemotherapy with FOLFOX. Parallel he was strictly followed up cardiologically in an outpatient clinic what certainly supported the oncological treatment. The patient survived 32 weeks from the first hospitalization and the progression free survival was 12 weeks from the chemotherapy initiation.
EN
Intraabdominal bleeding is a serious surgical problem, particularly in elderly patients following an anticoagulant therapy. It occurs, that abdominal haemorrhage is the first symptom of hepatocellular carcinoma, mostly in Asians and Africans, occasionally in Europeans. The article's author shows a case of an elderly man, treated by Acenocumarolum, in a haemorrhagic shock. During an operation a bleeding liver tumor was revealed. The surgical team performed an effectual tumor resection and stoped the bleeding.
EN
Intraabdominal bleeding is a serious surgical problem, particularly in elderly patients following an anticoagulant therapy. It occurs, that abdominal haemorrhage is the first symptom of hepatocellular carcinoma, mostly in Asians and Africans, occasionally in Europeans. The article's author shows a case of an elderly man, treated by Acenocumarolum, in a haemorrhagic shock. During an operation a bleeding liver tumor was revealed. The surgical team performed an effectual tumor resection and stoped the bleeding.
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