Peliosis hepatis complicating pregnancy: A rare entity

Abstract

Peliosis hepatis (PH) is a rare, benign condition of the liver characterized by the presence of blood-filled lacunar spaces in the parenchyma. It usually has a chronic presentation and is a rare cause of portal hypertension reported in adult patients. Its etiology is diverse and ranges from infectious agents to tumors to toxic substances and anabolic steroids; however, the cause remains unclear in 25-50% of patients. Similarly, the symptomatology and imaging findings are diverse. Biopsy is the definitive test to diagnose the condition. Herein, we present a case of a young female presenting in her seventh month of gestational amenorrhea with signs of portal hypertension and subsequently diagnosed to have PH. She was managed conservatively and delivered her baby normally. Later, she presented with spontaneous bacterial peritonitis and hepatic encephalopathy and developed hepatorenal syndrome. She later succumbed to her illness. The condition should be kept in the differential diagnosis of the atypical liver masses and liver diseases causing portal hypertension.

Pregnancy in Vascular Liver Disease

“…One patient presenting with massive post-partum hemorrhage and multiorgan failure had a peliotic liver incidentally found at laparotomy [30]. The second patient presenting with signs of portal hypertension in her seventh month of gestation was subsequently diagnosed with hepatic peliosis on liver biopsy; she delivered a baby at full term without any complication but died of portal hypertension related complications 2.5 years later [31].…”