Wicke Corinna, Pereira Philippe L, Neeser Eva, Flesch Ingo, Rodegerdts Enno A, Becker Horst Dieter
Department of General Surgery, University Hospital Tuebingen, Tuebingen, Germany.
Am J Obstet Gynecol. 2004 Jan;190(1):106-12. doi: 10.1016/j.ajog.2003.08.029.
Subcapsular liver hematoma formation has been reported in less than 2% of pregnancies complicated by HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome. The purpose of this study was to identify the main diagnostic and therapeutic options for management of these patients.
In this 10-year retrospective review, we performed a computer-directed search of all cases of confirmed HELLP syndrome with hepatic hematoma treated in the surgical department of our tertiary care referral medical center.
Five patients with subcapsular liver hematoma in HELLP syndrome could be identified. All patients received transabdominal ultrasound, computed tomography, or magnetic resonance imaging. Conservative treatment was successful in three patients. Emergency surgical intervention was necessary in two patients, including one liver transplantation.
The case series shows the full diagnostic spectrum with transabdominal ultrasound, computed tomography, and magnetic resonance imaging, as well as the different therapeutic options varying from conservative therapy to operative management, including liver transplantation.
据报道，在并发HELLP（溶血、肝酶升高、血小板减少）综合征的妊娠中，肝包膜下血肿形成的发生率低于2%。本研究的目的是确定这些患者管理的主要诊断和治疗选择。
在这项为期10年的回顾性研究中，我们对在我们三级医疗转诊中心外科治疗的所有确诊为HELLP综合征并伴有肝血肿的病例进行了计算机定向搜索。
可识别出5例HELLP综合征合并肝包膜下血肿的患者。所有患者均接受了经腹超声、计算机断层扫描或磁共振成像检查。3例患者保守治疗成功。2例患者需要紧急手术干预，其中1例进行了肝移植。
该病例系列展示了经腹超声、计算机断层扫描和磁共振成像的完整诊断范围，以及从保守治疗到手术管理（包括肝移植）的不同治疗选择。
