Abstract
BACKGROUND: Although hepatic adenomas (HA) account for less than 0.04% of all liver neoplasms, their occurrence in young women is rare but strongly associated with oral contraceptive use, particularly in the 20-40 years age group, with an annual incidence estimated at approximately 3 to 4 cases per 100000 population. CASE SUMMARY: We report the case of a previously healthy 30-year-old female patient, a regular user of combined oral contraceptives, who presented with acute hemorrhagic abdomen due to spontaneous rupture of a HA. The clinical presentation occurred after physical exertion and was with evidence of intra-abdominal bleeding. Initial management included selective hepatic arterial embolization as a conservative approach. Due to ongoing hemorrhage, an urgent left partial hepatectomy was indicated. CONCLUSION: The operation was completed without adverse events, and postoperative recovery was favorable. This report emphasizes the significance of prompt diagnosis and immediate surgical intervention when hemodynamic compromise occurs due to HA rupture.