Spontaneous liver rupture: A report of two cases
A 37-year-old male attended the emergency department with history of severe abdominal pain and bilious vomiting for a month, exacerbated for few days. There was no history of hematemesis or altered bowel habits. He had no other co-morbidities or past illness. While waiting in the emergency department he suddenly collapsed and was unresponsive. He was intubated and adequately resuscitated. Abdomen was distended and no mass was palpable.\nLaboratory investigations showed hemoglobin of 4. gm/dl, white cell count 15/cmm, platelet count 1.3 lacs/ccL and INR 1.01. Liver function tests showed normal bilirubin, albumin, and enzymes. FAST showed free fluid in the abdomen. At emergency laparotomy there was hemoperitoneum with clots around the liver and a large raw area with breach in the capsule in the segment six and seven. Perihepatic packing was done. He was monitored in the Intensive Care Unit and packs were removed during relaparotomy after 48 hours. He slowly improved and was discharged after seven days of hospitalization with no disability. The HPE of the liver tissue revealed mild inflammation. He was doing well on follow-up for six months [].