Computed tomography of fatal hepatic rupture due to peliosis hepatis

Hepatic rupture with subcapsular hematoma and hemoperitoneum is shown by CT in a patient with peliosis hepatis. Peliosis hepatis is pathologically characterized by blood-filled cystic spaces in the liver associated with the administration of anabolic androgenic steroids or oral contraceptive agents, particularly those with large components of estrogen. We report a fatal case in a patient receiving diethylstilbestrol for 3 years. In patients receiving these medications, peliosis hepatis should be considered in the differential diagnosis of low attenuation areas in the liver by CT. These patients are subject to increased risk of spontaneous hepatic rupture.