Spontaneous Hepatic Rupture with Intraperitoneal Hemorrhage without Underlying Etiology: A Report of Two Cases

Abstract

Spontaneous hepatic rupture is a rare event most often occurring in association with underlying liver disease or pregnancy. We report two unusual cases of hepatic rupture without any identifiable pathology, trauma, or comorbid conditions.

Subcapsular liver hematoma as a complication of an atypical hemolytic uremic syndrome

“…1 Renal microvasculature is predominantly affected but extrarenal ischemic events, mainly involving central nervous system, were also reported. 9 Since HELLP syndrome is an ATM like aHUS, 1 we speculate that SLH pathogenesis might be similar in both diseases. [3][4][5] Only three hemorrhagic events, affecting pulmonary vasculature, were previously reported in aHUS patients.…”

Subcapsular liver hematoma as a complication of an atypical hemolytic uremic syndrome

“…[6][7][8] SLH is a rare event that is mainly related with pregnancyinduced hypertension (preeclampsia and HELLP syndrome) and primary or metastatic liver tumors. 9 Since HELLP syndrome is an ATM like aHUS, 1 we speculate that SLH pathogenesis might be similar in both diseases. In HELLP syndrome, SLH is thought to be a consequence of hepatic blood flow obstruction due to fibrin deposits within hepatic sinusoids, resulting in periportal necrosis and intrahepatic hemorrhage.…”

Spontaneous Liver Rupture in the Setting of Autoimmune Disease and Periportal Edema

“…Spontaneous rupture of the liver resulting in life-threatening hemoperitoneum is a rare pathology usually associated with underlying hepatic diseases, including adenomas, malignancy, and hemangiomas [1]. Risk factors associated with spontaneous rupture of the liver include pregnancy, coagulation disturbances, connective tissue disorders, and hypereosinophilic syndrome [1,2].…”

“…Spontaneous rupture of the liver resulting in life-threatening hemoperitoneum is a rare pathology usually associated with underlying hepatic diseases, including adenomas, malignancy, and hemangiomas [1]. Risk factors associated with spontaneous rupture of the liver include pregnancy, coagulation disturbances, connective tissue disorders, and hypereosinophilic syndrome [1,2]. Spontaneous rupture of the liver may follow a pre-acute phase associated with non-specific gastrointestinal symptoms, such as nausea, vomiting, and abdominal pain, which can extend to as long as a month prior to rupture [2].…”