Peliosis hepatis (PH) is a rare condition characterized by the presence of cystic, blood filled cavities within the hepatic parenchyma. Regardless of the reason, surgery should be performed under meticulous control of hemorrhage, if it is thought to be unavoidable. In this case report, ominous results of clinically misdiagnosed PH have been presented. PH should be kept on mind in all patients with hepatic mass, especially presented by sudden onset distention of the abdomen. Every effort should be done for the differential diagnosis with other cystic conditions like hydatid cyst in endemic areas.

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