Peliosis hepatis is a rare pathological entity and may cause fatal hepatic hemorrhage and liver failure. Here, we present a young male patient with aplastic anemia, who had received long-term treatment with oxymetholone. The patient suffered from sudden onset of intra-abdominal hemorrhage with profuse hemoperitoneum. The patient was treated successfully with a right hemihepatectomy and is in good health after 13 postoperative months. We suggest that peliosis hepatis be considered in patients with hepatic parenchymal hematoma, especially in patients under prolonged synthetic anabolic steroid medication. The possibility of a potentially life-threatening complication of massive intra-abdominal bleeding should also be considered.

Intrahepatic portosystemic shunt (IPSS) is uncommon and usually follows trauma or iatrogenic injury, but spontaneous shunts may also occur, in patients without the evidence of chronic liver disease. Although interventional endovascular management of the shunts is the treatment of choice, a surgical approach can be used when the percutaneous approach fails. We report here a case of symptomatic spontaneous IPSS between the posteroinferior branch of right portal vein and the right inferior hepatic vein, which was successfully managed with laparoscopic closure of the hepatic vein. To the best of our knowledge, this is the first case report of laparoscopic management of spontaneous IPSS.