Abstract
Spontaneous liver rupture is a rare and life-threatening occurrence associated with high morbidity and mortality. We report a rare case of an elderly patient with a significant history of autoimmune disease who initially presented with cholestatic symptomatology that subsequently resulted in spontaneous liver rupture and hemorrhagic shock. An initial CT scan prior to the rupture showed periportal edema. In a patient with unexplained abdominal pain and imaging findings of periportal edema, emergency providers should have a lower threshold for suspecting the development of liver rupture or other hepatic pathologies. In the case of a potential liver rupture, admission for observation and early resuscitation can prove key to successful treatment.