Patricot L M, Dumont M, Duvernois J P, Baulieux J, Mercatello A
J Gynecol Obstet Biol Reprod (Paris). 1986;15(3):321-6.
The authors report a case of Peliosis of the liver and of the spleen that occurred at term after a normal pregnancy that lasted 38 weeks. The delivery was complicated by amniotic infection with hemorrhagic shock and uterine inertia that gave rise to the need for a sub-total hysterectomy in order to stop the bleeding. The progress of the case was made worse by the development of the disseminated intra-vascular coagulation syndrome with septicaemia and pulmonary oedema. When the operation was carried out to stop the bleeding it was noted that the liver was enlarged, hard, smooth and dark in colour and the histological specimen showed a major degree of Peliosis hepatis. The same lesions were found in the region of the spleen and a lymph node. The patient died 14 days after delivery of acute renal failure together with cerebral oedema and septic shock. The authors consider that the aetiology of the Peliosis could be due to hormone changes of pregnancy associated with septicaemia. The anatomical evolution of Peliosis hepatis to widespread necrosis of the parenchyma makes it possible to understand that the condition of diffuse intra-vascular coagulation will not improve in the presence of hepato-cellular insufficiency.
作者报告了一例肝脾紫癜症病例，该病例发生于足月顺产之后，孕期持续38周。分娩过程因羊膜腔感染并发出血性休克和子宫收缩乏力而复杂化，为止血不得不进行次全子宫切除术。弥散性血管内凝血综合征合并败血症和肺水肿使病情进一步恶化。在进行止血手术时，发现肝脏肿大、质硬、表面光滑且颜色暗黑，组织学标本显示为重度肝紫癜症。在脾脏和一个淋巴结区域也发现了同样的病变。患者在分娩后14天死于急性肾衰竭，伴有脑水肿和感染性休克。作者认为，紫癜症的病因可能是妊娠激素变化与败血症共同作用的结果。肝紫癜症发展为实质广泛坏死的解剖学演变过程，有助于理解在存在肝细胞功能不全的情况下，弥散性血管内凝血状况不会改善。
