Shirozu Kazuhiro, Kuramoto Sumiko, Kido Saki, Hayamizu Kengo, Karashima Yuji, Hoka Sumio
From the *Operating Rooms, Kyushu University Hospital, Fukuoka, Japan; †Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital, Fukuoka, Japan; ‡Department of Obstetrics and Gynecology, Kyushu University Hospital, Fukuoka, Japan; and §Department of Anesthesiology and Critical Care Medicine, Kyushu University Graduate School of Medicine, Fukuoka, Japan.
A A Case Rep. 2017 May 15;8(10):257-260. doi: 10.1213/XAA.0000000000000487.
We herein present a case of intramuscular hematoma that developed after transversus abdominis plane block in a patient undergoing cesarean delivery. The patient had HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) preoperatively. Ultrasonography-guided transversus abdominis plane block was performed at the end of surgery. Postoperatively, the platelet count and antithrombin III level decreased, and computed tomography revealed intramuscular hematomas that possibly were related to vascular injury and potential disseminated intravascular coagulation. We should be mindful of the possibility of intramuscular hematoma formation in patients with HELLP syndrome, even when using ultrasound guidance.
我们在此报告一例剖宫产患者在腹横肌平面阻滞术后发生肌内血肿的病例。该患者术前患有HELLP综合征（溶血、肝酶升高和血小板计数降低）。手术结束时进行了超声引导下的腹横肌平面阻滞。术后，血小板计数和抗凝血酶III水平下降，计算机断层扫描显示肌内血肿，可能与血管损伤和潜在的弥散性血管内凝血有关。即使使用超声引导，我们也应注意HELLP综合征患者发生肌内血肿的可能性。
