Abstract

MASCAGNI, Pietro et al. Spontaneous hepatic rupture in a bodybuilder: a case report and review of the literature. Rev. esp. enferm. dig. [online]. 2018, vol.110, n.4, pp.254-256. ISSN 1130-0108.  https://dx.doi.org/10.17235/reed.2017.5103/2017.

This article is the first description of a spontaneous hepatic rupture in a young bodybuilder with a history of clenbuterol and ephedrine alkaloid use.

The patient presented with a sudden mid-epigastric pain and vomiting. Hemoglobin levels decreased a few hours later and a computed tomography scan was performed which revealed a rupture of the right liver capsule and hemoperitoneum. Two attempts at transarterial embolization did not control the bleeding and a right hemihepatectomy was performed. The pathological report identified a hepatic adenoma, a capsular tear and diffuse peliosis hepatis. The patient was discharged in a good condition after eleven days.

Spontaneous hepatic ruptures are rare and life-threatening and are usually described in association with tumors, connective tissue diseases and gestosis. This article is a review of the available literature with regard to this condition, with a focus on its relation to peliosis hepatis and banned substance used by body image fanatics.

The present case highlights the challenging diagnosis of this potentially fatal liver complication in a healthy appearing male, the risk associated with the online trade of performance enhancing drugs and its relation with peliosis hepatis.

Keywords : Hemoperitoneum; Peliosis hepatis. Hepatocellular adenoma; Liver neoplasms; Hepatectomy; Performance-enhancing substances; Anabolic steroids; Chronic drug-induced liver injury.

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