title: Peliosis hepatis: Personal experience and literature review.
abstract: Peliosis hepatis (PH) is a disease characterized by multiple and small, blood-filled cysts within the parenchymatous organs. PH is a very rare disease, more common in adults, and when it affects the liver, it comes to the surgeon's attention only in an extremely urgent situation after the lesion's rupture with the resulting hemoperitoneum. This report describes the case of a 29-year-old woman affected by recurring abdominal pain. Computed tomography scans showed a hepatic lesion formed by multiple hypodense areas, which showed an early acquisition of the contrast during the arterial phase. Furthermore, it remained isodense with the remaining parenchyma during the late venous phase. We decided on performing a liver resection of segment VII while avoiding a biopsy for safety reasons. The histopathologic examination confirmed the diagnosis of focal PH. PH should always be considered in the differential diagnosis of hepatic lesions. Clinicians should discuss the possible causes and issues related to the differential diagnosis in addition to the appropriate therapeutic approach. The fortuitous finding of a lesion, potentially compatible with PH, requires elective surgery with diagnostic and therapeutic intents. The main aim is to prevent the risk of a sudden bleeding that, in absence of properly equipped structures, may have a fatal outcome.
authors.affiliation: Daniele Crocetti, Andrea Palmieri, Giuseppe Pedullà, Department of Surgery, "Pietro Valdoni", "Sapienza" University of Rome, Rome 00161, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Crocetti
authors.affiliation: Daniele Crocetti, Andrea Palmieri, Giuseppe Pedullà, Department of Surgery, "Pietro Valdoni", "Sapienza" University of Rome, Rome 00161, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Palmieri
authors.affiliation: Daniele Crocetti, Andrea Palmieri, Giuseppe Pedullà, Department of Surgery, "Pietro Valdoni", "Sapienza" University of Rome, Rome 00161, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pedullà
authors.affiliation: Daniele Crocetti, Andrea Palmieri, Giuseppe Pedullà, Department of Surgery, "Pietro Valdoni", "Sapienza" University of Rome, Rome 00161, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Pasta
authors.affiliation: Daniele Crocetti, Andrea Palmieri, Giuseppe Pedullà, Department of Surgery, "Pietro Valdoni", "Sapienza" University of Rome, Rome 00161, Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: D'Orazi
authors.affiliation: Daniele Crocetti, Andrea Palmieri, Giuseppe Pedullà, Department of Surgery, "Pietro Valdoni", "Sapienza" University of Rome, Rome 00161, Italy.
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Grazi
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008279:Magnetic Resonance Imaging; D010382:Peliosis Hepatis / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D011237:Predictive Value of Tests; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Hemoperitoneum; Hemorrhagic hepatic cysts; Liver mass; Peliosis hepatis; Surgical treatment