Focal hemorrhagic necrosis of the liver. A clinicopathological entity possibly related to oral contraceptives.

A 44-year-old woman who had been taking oral contraceptives for 10 yr developed abdominal pain and abnormalities of liver tests, which led to the discovery of multiple filling defects on liver scan and of large hepatic zones of decreased density on computerized tomography of the abdomen. These abnormalities were due to sharply demarcated areas of hepatic multilobular hemorrhagic necrosis, associated with marked changes of liver arterioles and small hepatic veins. Since oral contraceptives have been incriminated in the genesis of hepatic vascular alterations, the possible relationship between focal hemorrhagic necrosis of the liver and these agents is suggested.