[Peliosis hepatis with liver rupture]

The case of a 50-year-old woman with a ruptured liver caused by peliosis hepatis is presented. Death occurred three days after laparotomy for an acute abdomen with a clinical diagnosis of intra-abdominal hemorrhage. Autopsy findings including histology are presented and the possible pathogenetic mechanisms are discussed. There was neither evidence of a tumor nor of drug or toxin exposure. Known etiologic factors for this disorder are discussed on the basis of the medical literature. These include consumptive primary disorders, anabolic agents and oral contraceptives. The pathogenetic sequence involves damage to the endothelial cells of the hepatic sinuses and to the reticular fiber network. This case should make physicians aware of this infrequent iatrogenic disorder which is apparently increasing in its occurrence.