DR SHANTHI S,DR GIRIMURUGAN N,DR LAVANYA
DOI: https://doi.org/Background: Hepatic adenomas (HCAs) are rare benign liver tumors, strongly associated with oral contraceptive use and typically affecting young women. While often asymptomatic, large or symptomatic adenomas carry risks of rupture, hemorrhage, and malignant transformation. Resection is recommended for high-risk lesions. Anesthetic management of hepatic resection is challenging due to potential massive hemorrhage, need for meticulous fluid balance, and risk of postoperative hepatic dysfunction.
Case Presentation: We describe the anesthetic management of a 19-year-old female with seizure disorder who presented with recurrent abdominal pain. Imaging revealed a 6 cm hepatic adenoma in segments II and III of the left lobe. She underwent elective left hepatectomy under general anesthesia with invasive hemodynamic monitoring, careful volume management, and strategies to minimize blood loss. Intraoperative blood loss was limited to 300 mL, requiring transfusion of one unit of packed red blood cells and fresh frozen plasma. Postoperatively, she was electively ventilated, extubated on the first postoperative day, and had an uneventful recovery.
Conclusion: This case highlights that successful anesthetic management of hepatic adenoma resection requires careful preoperative preparation, intraoperative vigilance with blood conservation measures, and close postoperative monitoring. Low central venous pressure anesthesia, judicious fluid therapy, and multidisciplinary coordination ensured favorable outcomes in this young patient.
