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Postpartum spontaneous subcapsular hepatic hematoma related to preeclampsia.

Anyfantakis D, Kastanakis M, Fragiadakis G, Karona P, Katsougris N, Bobolakis E - Case Rep Emerg Med (2014)

Bottom Line: Diagnostic work-up was suggestive of a subcapsular right lob hepatic hematoma which was successfully managed conservatively.Timely diagnosis is necessary for the prevention of life-threatening events in mother and fetus.For this reason acute care physicians have to be vigilant of the condition and consider this in the differential diagnosis of epigastric pain during pregnancy and postpartum.

View Article: PubMed Central - PubMed

Affiliation: Primary Health Care Centre of Kissamos, Loulakaki 13, Lentariana, 73134 Chania, Crete, Greece.

ABSTRACT
Subcapsular hematoma of the liver represents an unusual clinical phenomenon in the pregnancy and postpartum period with serious complications in terms of fetal and maternal mortality. Here we report a case of a 32-year-old primiparous female at 36 weeks of gestation, admitted to a maternity ward of a private clinic for preeclampsia. The woman underwent an emergency caesarean section with the extraction of an alive foetus. A few hours after delivery, she was transferred to the emergency department of our institution complaining of severe epigastric pain. Diagnostic work-up was suggestive of a subcapsular right lob hepatic hematoma which was successfully managed conservatively. Timely diagnosis is necessary for the prevention of life-threatening events in mother and fetus. For this reason acute care physicians have to be vigilant of the condition and consider this in the differential diagnosis of epigastric pain during pregnancy and postpartum.

No MeSH data available.


Related in: MedlinePlus

Abdominal computed tomography demonstrating the existence of a large subcapsular hepatic hematoma.
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fig1: Abdominal computed tomography demonstrating the existence of a large subcapsular hepatic hematoma.

Mentions: Her vital signs on admission to our institution were all within normal limits except of an elevated level of blood pressure (185/95 mmHg). Initial laboratory work-up showed the following: hematocrit (HCt) 29.3% (normal range 35–47%), hemoglobin (Hb) 9 gr/dL (normal range 11.5–15.5 gr/dL), platelet count (PLT) 185000/μL (normal range 150000–450000/μL), white blood cell count (WBC) 12200 cells/mm3 (normal range 4000–11000 cells/mm3), aspartate-aminotransferase 67 U/L (normal range 0–38 U/L), alanine aminotransferase 111 U/L (normal range 4–36 U/L), and lactic dehydrogenase (LDH) 682 UL (normal range 240–480 UL). Coagulation profile included examination of partial thromboplastin time (PTT) and of activated partial thromboplastin time (aPTT) which were within normal ranges. Urine analysis demonstrated proteinuria. Physical examination disclosed a light tenderness of the right upper abdominal quadrant. Abdominal ultrasound disclosed subcapsular fluid collection in the right hepatic lobe. Further imaging included computed tomography (CT) of the abdomen which confirmed the diagnosis demonstrating a large well-circumscribed subcapsular liver hematoma with intact capsula (15 × 10 × 14 cm) in the right hepatic lobe (Figures 1(a) and 1(b)).


Postpartum spontaneous subcapsular hepatic hematoma related to preeclampsia.

Anyfantakis D, Kastanakis M, Fragiadakis G, Karona P, Katsougris N, Bobolakis E - Case Rep Emerg Med (2014)

Abdominal computed tomography demonstrating the existence of a large subcapsular hepatic hematoma.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150477&req=5

fig1: Abdominal computed tomography demonstrating the existence of a large subcapsular hepatic hematoma.
Mentions: Her vital signs on admission to our institution were all within normal limits except of an elevated level of blood pressure (185/95 mmHg). Initial laboratory work-up showed the following: hematocrit (HCt) 29.3% (normal range 35–47%), hemoglobin (Hb) 9 gr/dL (normal range 11.5–15.5 gr/dL), platelet count (PLT) 185000/μL (normal range 150000–450000/μL), white blood cell count (WBC) 12200 cells/mm3 (normal range 4000–11000 cells/mm3), aspartate-aminotransferase 67 U/L (normal range 0–38 U/L), alanine aminotransferase 111 U/L (normal range 4–36 U/L), and lactic dehydrogenase (LDH) 682 UL (normal range 240–480 UL). Coagulation profile included examination of partial thromboplastin time (PTT) and of activated partial thromboplastin time (aPTT) which were within normal ranges. Urine analysis demonstrated proteinuria. Physical examination disclosed a light tenderness of the right upper abdominal quadrant. Abdominal ultrasound disclosed subcapsular fluid collection in the right hepatic lobe. Further imaging included computed tomography (CT) of the abdomen which confirmed the diagnosis demonstrating a large well-circumscribed subcapsular liver hematoma with intact capsula (15 × 10 × 14 cm) in the right hepatic lobe (Figures 1(a) and 1(b)).

Bottom Line: Diagnostic work-up was suggestive of a subcapsular right lob hepatic hematoma which was successfully managed conservatively.Timely diagnosis is necessary for the prevention of life-threatening events in mother and fetus.For this reason acute care physicians have to be vigilant of the condition and consider this in the differential diagnosis of epigastric pain during pregnancy and postpartum.

View Article: PubMed Central - PubMed

Affiliation: Primary Health Care Centre of Kissamos, Loulakaki 13, Lentariana, 73134 Chania, Crete, Greece.

ABSTRACT
Subcapsular hematoma of the liver represents an unusual clinical phenomenon in the pregnancy and postpartum period with serious complications in terms of fetal and maternal mortality. Here we report a case of a 32-year-old primiparous female at 36 weeks of gestation, admitted to a maternity ward of a private clinic for preeclampsia. The woman underwent an emergency caesarean section with the extraction of an alive foetus. A few hours after delivery, she was transferred to the emergency department of our institution complaining of severe epigastric pain. Diagnostic work-up was suggestive of a subcapsular right lob hepatic hematoma which was successfully managed conservatively. Timely diagnosis is necessary for the prevention of life-threatening events in mother and fetus. For this reason acute care physicians have to be vigilant of the condition and consider this in the differential diagnosis of epigastric pain during pregnancy and postpartum.

No MeSH data available.


Related in: MedlinePlus