Spontaneous hepatic rupture in a bodybuilder: a case report and review of the literature

Abstract

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.

Spontaneous Hepatic Rupture in the Setting of Peliosis Hepatis and End-Stage Renal Disease

“…Treatment goals primarily focus on achieving durable hemostasis, often through conservative therapy or trans-arterial band embolization. For instance, in a case report by Mascagni et al, initial trans-arterial embolization followed by right hemi-hepatectomy successfully halted bleeding due to right hepatic capsule rupture and hemoperitoneum [ 12 ].…”

A Rare Case of Peliosis Hepatis in Infancy

“…Cessation of the offending drug [4] or treatment of the underlying condition [10,12] led to total regression of the hepatic lesions in several cases. In symptomatic patients, presenting with acute signs of intraperitoneal bleeding, treatment is directed towards controlling the bleeding and liver sparing surgery [15,16].…”

Atraumatic Spleen and Liver Rupture While Weightlifting during Epstein-Barr Virus Convalescence

“…Atraumatic liver rupture (ALR) is rarer than ASR and most commonly caused by hepatocellular carcinoma and other hepatic tumors. Other conditions associated with ALR include amyloidosis, peliosis hepatis, polyarteritis nodosa, systemic lupus erythematosus, acute fatty liver of pregnancy, and HELLP syndrome (hemolysis, elevated liver enzymes and low platelets) which is a complication of pregnancy (12). To our knowledge, there have been no previous reports of ALR in patients with infectious mononucleosis.…”