A 49-year-old man ingested 3 g of "Tusanqi powder" three times daily for 2 months. Subsequently, the patient developed fatigue, abdominal distension, and abdominal pain. The laboratory findings were as follows: TBIL: 34.6 micromol/L, DBIL: 18.73 micromol/L, ALB: 34.2 g/L, ALT: 446 U/L, AST: 543 U/L, ALP: 116.0 U/L, GGT: 103 U/L, PT: 14.0 s, PTA: 77.8%, and INR: 1.13. CT showed diffuse hepatomegaly and unevenly reduced density of the liver parenchyma. The liver parenchyma during the arterial and venous phases showed a characteristic "map-like" appearance and uneven enhancement. The hepatic veins were unclear, and ascites were present. After admission, the patient was diagnosed with HSOS and treated with low-molecular-weight heparin and warfarin. After 1 month of treatment, the patient's clinical symptoms disappeared and biochemical indices and imaging findings returned to normal. Warfarin was administered orally and monitored weekly to achieve an INR between 2.0 and 2.5. Three months after the patient was treated, a liver biopsy revealed that most liver tissues did not exhibit obvious inflammation and necrosis. Only a few areas still showed congestion in the hepatic sinus, with patchy and band-like inflammation and necrosis. Fibrotic embolism was observed in the central vein, and perisinusoidal fibrosis was also noted (Figure 3c and d).