What Is Liver Rupture?

Liver injuries are common in cases of injury to the abdomen. The liver can be ruptured as a result of traumatic injury due to impact or penetration. Impact injuries may occur as a result of some sort of motor vehicle crash, whereas penetration injury to the liver is typically caused by a gunshot wound, knife wound, or other foreign objects penetrating the body.

Liver rupture in cases where traumatic injury (such as penetrating injury) or blunt force are not involved are rare but do occur in some cases, such as in pregnancy, particularly with HELLP syndrome, and hepatic hemangiomas or peliosis hepatis. 

Injuries to the liver can result in small hematomas or large tears deep into hepatic tissue. Liver injuries can result in severe blood loss as several significant blood vessels are in the area. 

Ruptured liver symptoms¹

People with ruptured livers, or liver injuries in general, may be experiencing severe blood loss and may go into shock. The symptoms of shock include a quickened breathing rate, an increased heart rate, cold or bluish-colored skin, sweating, and confusion. 

People experiencing a ruptured liver also typically experience pain and tenderness within the abdomen, which can extend to the shoulder. 

Other symptoms of liver rupture may include nausea and vomiting, particularly in pregnant patients with HELLP syndrome. 

If severe internal bleeding occurs, the person may have swelling in the abdomen.

In cases of blunt trauma to the liver, bruising around the area can occur.

Can you die from liver rupture?

Liver rupture is a life-threatening injury. Depending on the degree of injury to the liver, blood loss may be severe. Bleeding from liver injury may be minimal. However, with extensive damage to the liver, severe blood loss may occur, which can lead to shock and death. 

What causes the liver to rupture?

Liver ruptures or liver injuries typically occur as a result of either penetrating injury or blunt trauma to the liver. 

Penetrating injuries involve a foreign object penetrating the skin, for example, a gunshot wound or stabbing injury. Blunt trauma generally is caused by direct impact with an object. 

Both types of injury can rupture the liver and its associated blood vessels. This can lead to bleeding within the organ or bleeding into other areas of the abdomen. 

How is liver rupture diagnosed?

In cases where the extent of the injury is severe, for example, if the person has been stabbed or shot, medical professionals may take patients straight to surgery.

However, if the injury isn’t as obvious, liver ruptures can be diagnosed through a computed tomography (CT) scan or ultrasound scan. 

What conditions put you at risk of having a liver rupture or rupture of growths in the liver?

Pregnancy

Liver rupture is rare during pregnancy; however, it is a complication of preeclampsia. Spontaneous liver rupture can occur in patients with hemolysis, elevated liver enzymes, and low platelets syndrome (HELLP).

Liver hemangioma

Liver hemangiomas are a common type of liver tumor. They’re made up of irregularly arranged blood vessels of varying sizes. Most cases of liver hemangiomas are asymptomatic. However, some people can have symptoms, usually due to rupture, either as a result of traumatic injury or spontaneously. 

Rupture of liver hemangiomas is uncommon but can be fatal due to the increased potential for hemorrhaging and severe blood loss. 

The exact incidence of hepatic rupture is not known. However, it is thought to be extremely rare. 

Hepatic abscess

The spontaneous rupture of liver abscesses rarely occurs, but it can be life-threatening. 

Liver cyst

Cysts within the liver are a common occurrence and can be found in approximately 1% of the population. The rupture of liver cysts is unusual and does not occur often, but it can be life-threatening. However, hydatid cysts due to echinococcosis can rupture much more frequently, with some data showing almost half of hydatid hepatic cysts rupturing.

How is liver rupture treated?

Liver injuries can heal without treatment in some cases. However, this isn’t always what happens. Liver rupture treatment can be complicated. Typically, people with ruptured livers are monitored closely in the hospital to ensure that no further injury is made and bleeding doesn’t occur spontaneously. 

If the bleeding caused by a ruptured liver doesn't stop quickly or it worsens, blood transfusions may be needed. In addition to blood transfusions, doctors can try to stop the blood vessels from bleeding by injecting the liver with substances such as fibrin glue, which seal the vessels, or packing the liver with hepatic gauze or mesh wrapping to compress the liver. 

The “Pringle maneuver” is a bleeding control strategy for liver rupture, where if manual compression of the liver fails to control hemorrhage, porta hepatis can be clamped, suspending flow through the portal venous and hepatic arterial systems.

If other methods don’t stop the bleeding or if blood loss is severe, the person typically undergoes surgery to stop the bleeding. These surgeries can involve the removal of part of the liver or may involve liver transplant as a last resort. 

The lowdown

A liver rupture is a severe and life-threatening injury. High volumes of blood pass through the liver at any given moment, and injury or rupture of the liver can lead to severe blood loss, which may result in shock and death. 

Treatments for liver rupture often involve surgery in order to stop blood loss. 

Frequently asked questions: 

Can your liver rupture?

Liver ruptures can occur either spontaneously or as a result of blunt force or penetrating injury. Liver ruptures are serious medical emergencies and should be treated quickly by medical professionals.

What happens if you rupture your liver?

Liver rupture can result in severe bleeding and hemorrhagic shock. Liver rupture can be life-threatening.