Fatal Hemoperitoneum Due to Isolated Splenic Peliosis

Isolated splenic peliosis is an exceedingly rare condition of unclear etiology characterized by blood filled cyst-like cavities in the primary mononuclear phagocytic organ. People with splenic peliosis are typically asymptomatic. However, splenic peliosis may present as an incidental mass on imaging mimicking a neoplasm during life, or present as sudden death after hemoperitoenum when ruptured, mimicking traumatic injury. Awareness of this condition is important to forensic pathologists so as to provide an accurate cause and manner of death.