Crocetti D, Palmieri A, Pedullà G, Pasta V, D’Orazi V, Grazi GL. Peliosis hepatis: Personal experience and literature review. World J Gastroenterol 2015; 21(46): 13188-13194 [PMID: 26675327 DOI: 10.3748/wjg.v21.i46.13188]
Corresponding Author of This Article
Valerio D’Orazi, MD, PhD, Department of Surgical Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy. info@valeriodorazi.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Dec 14, 2015; 21(46): 13188-13194 Published online Dec 14, 2015. doi: 10.3748/wjg.v21.i46.13188
Peliosis hepatis: Personal experience and literature review
Daniele Crocetti, Andrea Palmieri, Giuseppe Pedullà, Vittorio Pasta, Valerio D’Orazi, Gian Luca Grazi
Daniele Crocetti, Andrea Palmieri, Giuseppe Pedullà, Department of Surgery, “Pietro Valdoni”, “Sapienza” University of Rome, Rome 00161, Italy
Daniele Crocetti, Andrea Palmieri, Ph. D. Advanced Technologies in Surgery, “Sapienza” University of Rome, 00161 Rome, Italy
Vittorio Pasta, Valerio D’Orazi, Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
Valerio D’Orazi, Department of General Microsurgery, “Fabia Mater” Hospital, 00161 Rome, Italy
Gian Luca Grazi, Department of Hepatobiliary Surgery, “Regina Elena” Cancer Institute, 00144 Rome, Italy
Author contributions: Crocetti D, Palmieri A, and Pasta V designed and wrote the paper; Grazi GL and Palmieri A performed the surgery; D’Orazi V, Pedullà G, and Crocetti D performed the literature search and supported the writing of the paper; all authors read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Informed consent statement: Written informed consent was obtained from the patient for publication of this manuscript and any accompanying images and the study was carried out according to the Helsinki Declaration. A copy of the written consent is available for review by the Editor-in-Chief of this journal. In our study, we treated the patient with standard, and not experimental, therapies, and therefore, the request for authorization to the Ethics Committee does not apply.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Valerio D’Orazi, MD, PhD, Department of Surgical Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, 00161 Rome, Italy. info@valeriodorazi.com
Telephone: +39-330-431330
Received: April 19, 2015 Peer-review started: April 20, 2015 First decision: May 18, 2015 Revised: May 22, 2015 Accepted: August 29, 2015 Article in press: August 31, 2015 Published online: December 14, 2015 Processing time: 234 Days and 12.7 Hours
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.
Core tip: 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. We performed a liver resection of segment VII while avoiding biopsy for safety reasons. The histopathologic examination confirmed the diagnosis of focal hepatic peliosis. Surgery was successful and the patient had a good recovery.
