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妊娠晚期肝细胞腺瘤自发性破裂1例罕见病例。

A Rare Case of a Spontaneously Ruptured Hepatocellular Adenoma in the Third Trimester of Pregnancy.

作者信息

Kountouri Ismini, Kokkali Eftychia, Giotas Amyntas, Katsarelas Ioannis, Dimasis Periklis

机构信息

Department of General Surgery, General Hospital of Katerini, Katerini, GRC.

Department of Radiology, General Hospital of Katerini, Katerini, GRC.

出版信息

Cureus. 2024 Oct 26;16(10):e72447. doi: 10.7759/cureus.72447. eCollection 2024 Oct.

DOI:10.7759/cureus.72447
PMID:39600766
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11588674/
Abstract

This case report details the management of a 29-year-old primigravida who presented at 35 weeks of gestation with abdominal pain and vomiting. The patient exhibited tachycardia and fetal bradycardia, with laboratory findings indicating severe anemia and elevated liver enzymes. An emergency cesarean section was performed due to hemodynamic instability, during which a ruptured hepatocellular adenoma (HCA) was discovered, necessitating an atypical left hepatectomy. Despite successful maternal recovery, the neonate succumbed to multiple organ failure. Hepatocellular adenomas (HCA), also known as hepatic adenomas, are rare benign epithelial liver tumors that predominantly occur in women during their reproductive years and have been strongly associated with the intake of oral contraceptives. This case highlights the rare occurrence of HCA rupture during pregnancy, emphasizing the importance of prompt diagnosis and intervention to prevent life-threatening complications. Additionally, it underscores the need for careful monitoring and potential preemptive intervention in pregnant women with large HCAs due to the elevated risk of rupture.

摘要

本病例报告详细介绍了一名29岁初产妇的治疗情况,该产妇在妊娠35周时出现腹痛和呕吐。患者表现出心动过速和胎儿心动过缓,实验室检查结果显示严重贫血和肝酶升高。由于血流动力学不稳定,进行了紧急剖宫产,术中发现肝细胞腺瘤(HCA)破裂,需要进行非典型左半肝切除术。尽管产妇成功康复,但新生儿死于多器官功能衰竭。肝细胞腺瘤(HCA),也称为肝腺瘤,是一种罕见的肝脏良性上皮性肿瘤,主要发生在育龄妇女中,并且与口服避孕药的摄入密切相关。本病例突出了妊娠期间HCA破裂的罕见情况,强调了及时诊断和干预以预防危及生命的并发症的重要性。此外,它强调了对患有大型HCA的孕妇进行仔细监测和潜在的预防性干预的必要性,因为破裂风险较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb4a/11588674/12978d2529bd/cureus-0016-00000072447-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb4a/11588674/94ad073097af/cureus-0016-00000072447-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb4a/11588674/92673efd1d7a/cureus-0016-00000072447-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb4a/11588674/12978d2529bd/cureus-0016-00000072447-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb4a/11588674/94ad073097af/cureus-0016-00000072447-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb4a/11588674/92673efd1d7a/cureus-0016-00000072447-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb4a/11588674/12978d2529bd/cureus-0016-00000072447-i03.jpg

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