Seren G, Morel J, Jospe R, Mahul P, Dumont A, Cuileron M, Tiffet O, Auboyer C
Service de réanimation polyvalente, hôpital Nord, CHU de Saint-Etienne, 42055 Saint-Etienne cedex 02, France.
Ann Fr Anesth Reanim. 2006 Oct;25(10):1067-9. doi: 10.1016/j.annfar.2006.07.077. Epub 2006 Sep 26.
We report a case of spontaneous hepatic rupture secondary to HELLP syndrome. A favourable evolution was observed after massive transfusion and surgical management limited to hepatic packing. Subcapsular hepatic haematoma is a rare complication of preeclampsia occurring mainly in the context of HELLP syndrome. A high maternal and foetal mortality is observed. Different therapeutic options are presented including medical, surgical and radiological interventions. A unique strategy cannot be defined. Multidisciplinary approach seems mandatory. Surgery should remain as less aggressive as possible.
我们报告一例因HELLP综合征继发的自发性肝破裂病例。在大量输血及仅行肝填塞的手术处理后,观察到病情向好的方向发展。肝包膜下血肿是先兆子痫的一种罕见并发症,主要发生在HELLP综合征的背景下。观察到母婴死亡率较高。文中介绍了包括药物、手术及放射学干预在内的不同治疗选择。无法确定一种独特的策略。多学科方法似乎是必要的。手术应尽可能采取微创方式。