Background : Hepatic peliosis is a rare benign vascular condition characterized by dilatation of sinusoidal blood filled spaces within the liver, this entity could mimic malignant disease. Patients are usually asymptomatic, and this entity could be discover incidentally on imaging or autopsy. The importance of this case is that we have an emergency room equipped with state-of-the-art imaging equipment as well as availability of care for an emergency that required an operating room immediately.

Methods : A 24-year-old man, without comorbidities, presented sudden pain in the abdomen in the right flank and back that did not allow him to continue with his work, so he was transferred to the emergency service. In the evaluation he presents sweaty, tachycardia, with pain that partially responds with analgesics. In the imaging studies, a tumor that encompasses the right lobe of the liver is found in the ultrasound, later in the evaluation by tomography a hepatic tumor of the right lobe is found with contrast output to the abdominal cavity, for which it is decided to go inmediately the operating room, in joint work with the Anesthesiology, Cardiology and Intensive Care Unit of the clinic.

Results : In the operating room, there is active hemoperitoneum approximately 2200 cc of blood in the cavity, a tumor that encompasses the right hepatic lobe with rupture of the hepatic capsule in segment VIII. An anatomical right hepatectomy was performed, using pringle maneuver, right selective hemipringle, hanging maneuver, and hepatic transaction with bipolar and ligasure, as well as mechanical vascular suture, polymer and metal clips.

Conclusions : Multidisciplinary management by anesthesiologist and intensive care unit, which evolves favorably, did not present postoperative bleeding, biliary fistula, or posthepatectomy liver failure. He was discharged seventh postoperative day, continue controls by with monitoring of liver function, and controls with Liver MRI.