Gonçalves Cristina, Aguilar Sara, Prior Ana Rita, Oliveira Graça
Department of Paediatrics, Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
BMJ Case Rep. 2013 Jun 3;2013:bcr2013009074. doi: 10.1136/bcr-2013-009074.
Subcapsular haematoma of the liver rarely occurs in neonates and the diagnosis is often missed or delayed. It is a catastrophic condition that can be caused by maternal, placentar or fetal factors. A high index of suspicion is essential for early identification and stabilisation of babies with such a pathology. In a newborn with hypovolemic shock and abdominal distension, haemoperitoneum should be suspected and, along with exclusion of other aetiologies, supportive therapy should be instituted. The hepatic subcapsular haematoma has a non-specific presentation, and should be considered in very low birth weight infants with hypovolemic shock. Abdominal ultrasonography is the investigation of choice. It can delineate the lesion well, differentiate it from neoplasms, rule out rupture and aid in serial follow-up. We report a premature newborn who had this uncommon condition in the early neonatal period and survived without sequelae.
肝脏包膜下血肿在新生儿中很少见，诊断常常被漏诊或延误。它是一种可由母体、胎盘或胎儿因素引起的严重疾病。对于患有这种病症的婴儿，高度的怀疑指数对于早期识别和稳定病情至关重要。在患有低血容量性休克和腹胀的新生儿中，应怀疑有血腹症，并且在排除其他病因的同时，应开始进行支持性治疗。肝包膜下血肿的表现不具特异性，对于患有低血容量性休克的极低出生体重儿应考虑此病。腹部超声检查是首选的检查方法。它可以很好地描绘病变，将其与肿瘤区分开来，排除破裂情况并有助于进行连续随访。我们报告了一名早产新生儿，其在新生儿早期患有这种罕见病症，且存活下来没有后遗症。
