{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T21:33:24Z","timestamp":1793568804327,"version":"4.5.0"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T00:00:00Z","timestamp":1774742400000},"content-version":"vor","delay-in-days":28,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical Research Program of Jiangsu Provincial Health Commission","award":["Z2023017"],"award-info":[{"award-number":["Z2023017"]}]},{"name":"Suqian Science and Technology Program","award":["S202317"],"award-info":[{"award-number":["S202317"]}]},{"name":"Suqian Talent Elite Program","award":["SQCG202409"],"award-info":[{"award-number":["SQCG202409"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Hemorrhagic rupture of a simple liver cyst is a rare clinical occurrence. Whether external physical forces can trigger such rupture remains unclear. A 47-year-old woman presented with acute abdominal pain 72\u00a0h following an electrical muscle stimulation (EMS) session for weight reduction. Cross-sectional imaging demonstrated a 10-cm ruptured cyst in the right hepatic lobe with associated 1.5\u00a0l of hemoperitoneum. Her platelet count was 88\u2009\u00d7\u2009109\/l. The patient successfully underwent emergency laparoscopic cyst deroofing with povidone-iodine sclerotherapy and did not require blood transfusion. Histopathology confirmed a simple biliary cyst, and a follow-up magnetic resonance imaging at 6 months showed no recurrence. This case suggests that vigorous muscular contractions from EMS may act as a potential precipitating factor for the rupture of large liver cysts, particularly in the context of mild thrombocytopenia, while spontaneous rupture cannot be entirely excluded as an alternative etiology. Laparoscopic management with chemical ablation represents an effective emergency treatment strategy.<\/jats:p>","DOI":"10.1093\/jscr\/rjag209","type":"journal-article","created":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T09:38:58Z","timestamp":1774777138000},"source":"Crossref","is-referenced-by-count":1,"title":["Spontaneous rupture and hemorrhage of a large simple hepatic cyst following external electrical muscle stimulation: a case managed by emergency laparoscopy"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7553-2285","authenticated-orcid":false,"given":"Wei","family":"Feng","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University , No. 138, Huanghe South Road, Suqian, Jiangsu 223800 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingwang","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University , No. 138, Huanghe South Road, Suqian, Jiangsu 223800 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qile","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University , No. 138, Huanghe South Road, Suqian, Jiangsu 223800 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongbo","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University , No. 138, Huanghe South Road, Suqian, Jiangsu 223800 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanlai","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Affiliated Suqian Hospital of Xuzhou Medical University , No. 138, Huanghe South Road, Suqian, Jiangsu 223800 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,3,29]]},"reference":[{"key":"2026032905385293800_ref1","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1016\/j.jhep.2016.04.001","article-title":"EASL clinical practice guidelines on the management of benign liver tumours","volume":"65","author":"European Association for the Study of the Liver (EASL)","year":"2016","journal-title":"J Hepatol"},{"key":"2026032905385293800_ref2","doi-asserted-by":"publisher","first-page":"3543","DOI":"10.3748\/wjg.v19.i23.3543","article-title":"Evaluation of hepatic cystic lesions","volume":"19","author":"Lantinga","year":"2013","journal-title":"World J Gastroenterol"},{"key":"2026032905385293800_ref3","article-title":"Extraperitoneal hemorrhagic rupture of a simple hepatic cyst. 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