[Hepatic tuberculosis as a rare cause of massive intrabdominal bleeding]

We admitted 70 years old woman with signs of acute abdomen and severe hemorrhagic shock. The urgent laparatomy was done. We found necrosis of the right liver lobe with signs of diffuse hepatic disease. We removed necrotic liver tissue and applied perihepatic package in order to stop bleeding. Patient was sent to ICU. Six days after first operation operative removal of hepatic package was done and cholecystectomy due to gangrene of gallbladder. Patohistology revealed miliary tuberculosis of liver with necrosis. Laboratory findings showed severe hypoalbuminemia, leucopenia and anemia. Tenth day after first operation, patient developed ARDS that could not be treated successfully, so patient died next day.