Peliosis Hepatis

(See also Overview of Vascular Disorders of the Liver Overview of Vascular Disorders of the Liver The liver has a dual blood supply. The portal vein (which is rich in nutrients and relatively high in oxygen) provides two thirds of blood flow to the liver. The hepatic artery (which is oxygen-rich)... read more .)

Measuring a few millimeters to about 3 cm in diameter, the cysts of peliosis hepatis often lack a cell lining and are surrounded by hepatocytes. Some have an endothelial cell lining, accompanied by dilated hepatic sinusoids. The cause is probably damage to the sinusoidal lining cells. Peliosis hepatis is associated with use of hormones (eg, anabolic steroids, oral contraceptives, glucocorticoids), tamoxifen, vinyl chloride, vitamin A, and, particularly in kidney transplant recipients, azathioprine.

Peliosis hepatis is usually asymptomatic, but occasionally cysts rupture, resulting in hemorrhage and sometimes causing death. Some patients develop overt liver disease, characterized by jaundice Jaundice Jaundice is a yellowish discoloration of the skin and mucous membranes caused by hyperbilirubinemia. Jaundice becomes visible when the bilirubin level is about 2 to 3 mg/dL (34 to 51 micromol/L)... read more , hepatomegaly, and liver failure. Acute Liver Failure Acute liver failure is caused most often by drugs and hepatitis viruses. Cardinal manifestations are jaundice, coagulopathy, and encephalopathy. Diagnosis is clinical. Treatment is mainly supportive... read more

Mild cases may be detected incidentally during imaging tests Imaging Tests of the Liver and Gallbladder Imaging is essential for accurately diagnosing biliary tract disorders and is important for detecting focal liver lesions (eg, abscess, tumor). It is limited in detecting and diagnosing diffuse... read more done because liver test Laboratory Tests of the Liver and Gallbladder Laboratory tests are generally effective for the following: Detecting hepatic dysfunction Assessing the severity of liver injury Monitoring the course of liver diseases and the response to treatment... read more results are slightly abnormal or for other reasons. Ultrasonography Ultrasonography Imaging is essential for accurately diagnosing biliary tract disorders and is important for detecting focal liver lesions (eg, abscess, tumor). It is limited in detecting and diagnosing diffuse... read more or CT Computed tomography (CT) Imaging is essential for accurately diagnosing biliary tract disorders and is important for detecting focal liver lesions (eg, abscess, tumor). It is limited in detecting and diagnosing diffuse... read more can detect cysts. Most cases are not treated.