Peliosis hepatis

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Peliosis hepatis
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Often asymptomatic, but may include abdominal pain, hepatomegaly, and jaundice
Complications	Liver failure, hemorrhage, portal hypertension
Onset	Variable
Duration	Chronic
Types	N/A
Causes	Bartonella henselae, Bartonella quintana, anabolic steroids, oral contraceptives, tuberculosis, cancer
Risks	Immunosuppression, HIV/AIDS, organ transplantation
Diagnosis	Imaging studies (e.g., CT scan, MRI), liver biopsy
Differential diagnosis	Hemangioma, liver metastases, nodular regenerative hyperplasia
Prevention	N/A
Treatment	Discontinuation of causative drugs, treatment of underlying infection, supportive care
Medication	N/A
Prognosis	Variable, depends on underlying cause and complications
Frequency	Rare
Deaths	N/A

A rare vascular condition of the liver

Peliosis hepatis is a rare vascular condition characterized by the presence of multiple, randomly distributed, blood-filled cystic spaces within the liver. These spaces can vary in size and are not lined by endothelial cells, distinguishing them from other vascular lesions of the liver.

Pathophysiology

Peliosis hepatis involves the formation of blood-filled cavities within the liver parenchyma. The exact mechanism of formation is not fully understood, but it is believed to be associated with damage to the sinusoidal endothelial cells, leading to blood extravasation and cavity formation. The condition can be associated with various factors, including anabolic steroid use, tuberculosis, cancer, and certain medications such as azathioprine and oral contraceptives.

Clinical Presentation

Patients with peliosis hepatis may be asymptomatic or present with non-specific symptoms such as abdominal pain, hepatomegaly, or signs of liver dysfunction. In some cases, peliosis hepatis can lead to serious complications such as liver failure, portal hypertension, or hemoperitoneum due to rupture of the blood-filled cavities.

Diagnosis

The diagnosis of peliosis hepatis is often incidental, discovered during imaging studies or surgery for other conditions. Ultrasound, CT scan, and MRI can reveal the presence of cystic lesions in the liver. Definitive diagnosis is usually made through liver biopsy, which shows the characteristic blood-filled spaces without endothelial lining.

Treatment

Treatment of peliosis hepatis depends on the underlying cause. Discontinuation of causative medications or treatment of associated conditions can lead to resolution of the lesions. In severe cases, surgical intervention may be necessary to manage complications such as bleeding.

Prognosis

The prognosis of peliosis hepatis varies depending on the underlying cause and the presence of complications. In many cases, the condition is benign and resolves with appropriate management of the underlying cause. However, severe cases with complications can have a poor prognosis.

See also

• Liver disease
• Hepatology
• Vascular lesions of the liver