Hepatic rupture is an acute disruption of liver parenchyma that may follow blunt trauma, penetrating injury, spontaneous bleeding from tumours, or iatrogenic insults during percutaneous procedures. Clinical expression ranges from contained subcapsular haematoma to massive intraperitoneal haemorrhage and haemodynamic collapse. Recognition of the constellation below is essential for rapid intervention. Acute abdominal painSudden, severe right-upper-quadrain pain often radiates to the shoulder tip (phrenic nerve irritation) and is exacerbated by movement, coughing, or deep inspiration. Peritoneal irritationBlood and bile extravasate onto the peritoneal surface, producing guarding, rebound tenderness and board-like rigidity. Shoulder-tip pain may dominate when the patient is supine. Hypovolaemic... Learn more