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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

Follow-up CT scan showing decrease of the dimensions of the hematoma.
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fig2: Follow-up CT scan showing decrease of the dimensions of the hematoma.

Mentions: Since no active bleeding was identified at that time, the patient was managed conservatively with fluid infusions, antihypertensive medication, and antibiotherapy. Her clinical status as well as hematocrit and liver enzymes levels was improved significantly during the following days. A follow-up CT scan in the 15th hospital day disclosed a significant decrease in the dimensions of the hematoma (Figure 2). The patient was discharged home on the 19th day of hospitalization following an uneventful clinical course. An ultrasound and magnetic resonance imaging (MRI) abdominal scan performed 3 months and 5 months later, respectively, showed that hematoma had further reduced to 5.9 × 3.5 cm (Figure 3) and 2 × 3 × 4.5 cm (Figure 4). Nine-month postpartum abdominal ultrasound showed no residual hematoma.


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)

Follow-up CT scan showing decrease of the dimensions of the hematoma.
© Copyright Policy
Related In: Results  -  Collection

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

fig2: Follow-up CT scan showing decrease of the dimensions of the hematoma.
Mentions: Since no active bleeding was identified at that time, the patient was managed conservatively with fluid infusions, antihypertensive medication, and antibiotherapy. Her clinical status as well as hematocrit and liver enzymes levels was improved significantly during the following days. A follow-up CT scan in the 15th hospital day disclosed a significant decrease in the dimensions of the hematoma (Figure 2). The patient was discharged home on the 19th day of hospitalization following an uneventful clinical course. An ultrasound and magnetic resonance imaging (MRI) abdominal scan performed 3 months and 5 months later, respectively, showed that hematoma had further reduced to 5.9 × 3.5 cm (Figure 3) and 2 × 3 × 4.5 cm (Figure 4). Nine-month postpartum abdominal ultrasound showed no residual hematoma.

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