Curious cases of spontaneous hepatic rupture - An autopsy based case series

Spontaneous abdominal haemorrhage is defined as the presence of Intra-abdominal haemorrhage from non-traumatic and non-iatrogenic causes. Spontaneous hepatic rupture is one of the rare cause of intra-abdominal haemorrhage. Literature notifies causes of spontaneous hepatic rupture as hepatic adenoma, hepato-cellular carcinoma, HELLP syndrome (Hemolysis, elevated liver enzymes and low platelets) in pregnant females, cysts, haemangiomas, coagulopathies, banned substance abuse etc. Imaging techniques like Focused Abdominal Ultrasonogram for trauma (FAST) and Computed Tomography are standard imaging techniques for diagnosis of spontaneous hepatic rupture. Angiographic coiling, hepatic artery ligation, peri-hepatic packing, liver resection, liver transplantation are the management interventions to reduce morbidity and mortality in these cases. The present case series reports autopsy based examination of three rare cases of spontaneous liver rupture. An attempt to probe the cause of spontaneous liver rupture is made via meticulous autopsy examination.