Dechaud H, Marsollier C, Bezard-Falgas X, Bruelle P, Ripart S, Mares P
Service de Gynécologie-Obstétrique, CHRU Carémeau, Nîmes.
J Gynecol Obstet Biol Reprod (Paris). 1992;21(8):959-62.
A sub-capsular haematoma of the liver is a rare but very serious complication of pregnancy. We report a case of a primipara whose pregnancy was first complicated by hypertension, then by a haematoma of the liver at the 28th week of amenorrhoea. It was diagnosed because of the clinical symptoms associated with the hypertension and a pain in the right hypochondrium and nausea. The diagnosis of haematoma of the liver was made before rupture and confirmed by ultrasound of the liver and by tomodensitometry made it possible to avoid operating on the liver during the laparotomy that was carried out to terminate the pregnancy. Regular X-ray follow-ups showed that the lesion had regressed in six months. MRI investigation of the parenchyma of the liver showed no cause of the lesions. If there is even the slightest suspicion of a haematoma of the liver in pregnancy, ultrasound nowadays should be carried out because it is indispensable to make the diagnosis.
肝包膜下血肿是妊娠罕见但非常严重的并发症。我们报告一例初产妇,其妊娠首先并发高血压,然后在闭经第28周时出现肝血肿。因与高血压相关的临床症状以及右季肋部疼痛和恶心而得以诊断。肝血肿在破裂前确诊,并通过肝脏超声和计算机断层扫描得以证实,这使得在为终止妊娠而进行的剖腹手术中避免了肝脏手术。定期X线随访显示病变在六个月内消退。肝脏实质的MRI检查未发现病变原因。如今,如果对妊娠期间的肝血肿哪怕有最轻微的怀疑,都应进行超声检查,因为它对诊断必不可少。