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. 2013;4(5):508-10.
doi: 10.1016/j.ijscr.2013.01.030. Epub 2013 Feb 17.

Spontaneous hepatic rupture in a patient with peliosis hepatis: A report of one case

Daniele Sommacale  1 , Elisa Palladino, Esther L Tamby, Marie Danielle Diebold, Ali Reza Kianmanesh
Affiliations

Spontaneous hepatic rupture in a patient with peliosis hepatis: A report of one case

Daniele Sommacale et al. Int J Surg Case Rep. 2013.

Abstract

Introduction: Liver rupture is a serious event that is most commonly due to blunt abdominal trauma. We present a case of peliosis hepatis in a patient admitted for acute pyelonephritis who developed hemoperitoneum due to spontaneous hepatic rupture from this rare liver condition.

Presentation of case: We report a 44 year-old woman who presented to our hospital with acute pyelonephrititis and hemoperitoneum due to spontaneous hepatic rupture from peliosis hepatis. Physicians should be aware of this rare condition in patients who present with non-traumatic hepatic rupture with hemoperitoneum.

Discussion: PH should be considered in all patients with known risk factors who present with typical morphological changes or a hepatic mass, especially when the cause of sudden intraperitoneal hemorrhage is obscure.

Conclusion: Peliosis hepatis is most often asymptomatic and an incidental finding at autopsy. In symptomatic patients, surgery should be reserved for those patients whose hemorrhage is-life-threatening. Familiarity with the imaging characteristics can help in earlier diagnosis of peliosis hepatis.

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Figures

Fig. 1
Fig. 1
CT of the abdomen showing the normal liver.
Fig. 2
Fig. 2
CT of the abdomen showing many areas hypodenses in right liver suggesting acute blood collection in these areas.
Fig. 3
Fig. 3
Surface of the liver parenchyma showing many hemorrhagic areas.
Fig. 4
Fig. 4
(a) Liver Biopsie: hémorrhagic necrosis on healthy liver. (b) Liver Biopsie: hémorrhagic necrosis on healthy liver.
Fig. 5
Fig. 5
Late arterial phase from a hepatic angiogram shows hepatic artery branches displaced by a multiple lesions in the right liver (solid arrows). Puddling of contrast from capillaries is seen.
See this image and copyright information in PMC

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