<p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p> <p>Spontaneous liver rupture is uncommon, difficult to diagnose and carries a universally high mortality. It
has been well documented to occur as a complication of primary or secondary hepatic malignancy.
Similarly, there are 28 cases of ruptured haemangiomata described in the world literature. It is also well
described in severe pregnancy-induced hypertension and is said to carry a mortality of 18% for patients
treated by packing and drainage of the haematoma and 75% for patients treated with liver resection.</p> <p>Two female patients aged 60 and 61 presented to our accident and emergency department. One had a
history of hypertension only and the other a history of a bleeding diathesis from the lupus anticoagulant.
Both presented with hypotension and abdominal pain and both were diagnosed by abdominal CT scan.
One was treated with hepatic artery ligation and tamponade and the other with liver resection and
correction of the coagulopathy. Neither had any evidence of a ruptured haemangioma or tumour at
laparotomy or on histological examination, and both are alive and well.</p> <p>The conclusions to be drawn from this review and our own recent experience is that the treatment of
choice for ruptured haemangiomata is liver resection and, for rupture during pregnancy, is tamponade
with packs and evacuation of the haematoma. Hepatic arteriography and embolisation, if possible, is a
useful adjunct. Correction ofany coagulopathy is essential. We can only speculate that the aetiology in our
patients was uncontrolled hypertension in one and coagulopathy in the other.</p>
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HPB Surg. 1996; 9(4):257-260