[A 38-year-old patient with gastroenteritis and unusual liver lesions]

A 38-year-old female presented with symptoms of gastroenteritis including fatigue and epigastric pain. An abdominal ultrasound indicated on the basis of raised liver values showed multiple liver lesions. However, additional imaging using contrast-enhanced ultrasound (CEUS), computer tomography (CT) as well as a magnetic resonance tomography (MR) failed to clarify the diagnosis. A fine needle biopsy revealed the histological diagnosis of peliosis hepatis. After discontinuing oral contraceptive medication, follow-up showed a steady state with clinical well being for at least 24 months.Peliosis hepatis is a rare hepatic disorder involving "bloody cysts" in the liver. Aetiology and pathogenesis remain unclear, but medication or toxins as possible triggering factors are discussed. Different clinical courses have been reported, including total asymptomatic state, unspecific fatigue, epigastric pain, as well as fulminant cases with liver rupture and bleeding complications.