Liakou Paraskevi, Batsiou Anastasia, Konstantinidi Aikaterini, Theodoraki Martha, Taliaka Kopanou Paschalia, Tavoulari Evangelia-Filothei, Tsantes Andreas G, Piovani Daniele, Bonovas Stefanos, Tsantes Argirios E, Iacovidou Nicoletta, Sokou Rozeta
Neonatal Intensive Care Unit, "Agios Panteleimon" General Hospital of Nikea, 18454 Piraeus, Greece.
Laboratory of Haematology and Blood Bank Unit, "Attiko" Hospital, School of Medicine, National and Kapodistrian University of Athens, 1 Rimini Str., 12462 Athens, Greece.
J Clin Med. 2022 Sep 26;11(19):5684. doi: 10.3390/jcm11195684.
The subcapsular hematoma (SLH) of the liver is a rare finding in living infants. The clinical presentation of rupture is non-specific, with the signs of hypovolemic shock dominating. The causes are several, with prematurity, trauma and sepsis playing a leading role in the creation of an SHL. Umbilical vein catheterization and an increased bleeding tendency have also been associated with this usually fatal diagnosis. Abdominal ultrasonography, among other imaging methods, comprises the gold standard examination for early diagnosis. It should be differentiated from other possible causes of shock, such as sepsis and intraventricular hemorrhage, which have similar clinical presentation. We report a case series of three very low birth weight preterms (VLBW), with an SHL, during the first days of life, one of which survived from this usually catastrophic condition. A comprehensive review of the literature regarding this clinical entity was also conducted. A high index of suspicion is essential for early identification of such a case, with conservative or surgical treatment being the way to go.
肝包膜下血肿（SLH）在活产婴儿中是一种罕见的发现。破裂的临床表现不具有特异性，以低血容量性休克的体征为主。病因有多种，早产、创伤和败血症在肝包膜下血肿的形成中起主要作用。脐静脉插管和出血倾向增加也与这种通常致命的诊断有关。腹部超声检查以及其他成像方法是早期诊断的金标准检查。它应与其他可能导致休克的原因相鉴别，如败血症和脑室内出血，它们具有相似的临床表现。我们报告了一组病例，三名极低出生体重早产儿（VLBW）在出生后的头几天出现了肝包膜下血肿，其中一名从这种通常灾难性的情况中存活下来。我们还对有关这一临床实体的文献进行了全面综述。高度怀疑指数对于早期识别此类病例至关重要，保守治疗或手术治疗是可行的方法。
