Uploaded September 2026 | Updated September 2026, 1 week ago
A 46-year-old man with cirrhosis presented to the emergency department with a 1-week history of left flank pain. He reported no recent trauma, medical procedures, or use of anticoagulant or antiplatelet medications. His heart rate was 128 beats per minute, and his blood pressure was 64/37 mm Hg. Laboratory studies were notable for anemia, severe thrombocytopenia, and findings consistent with advanced liver disease. Physical examination and contrast-enhanced computed tomography of the abdomen are shown. Submit your answer at NEJM.org (nej.md/IC09032026)
A 46-year-old man with cirrhosis presented to the emergency department with a 1-week history of left flank pain. He reported no recent trauma, medical procedures, or use of anticoagulant or antiplatelet medications. His heart rate was 128 beats per minute, and his blood pressure was 64/37 mm Hg. Laboratory studies were notable for anemia, severe thrombocytopenia, and findings consistent with advanced liver disease. Physical examination and contrast-enhanced computed tomography of the abdomen are shown. Submit your answer at NEJM.org (nej.md/IC09032026)
