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一名重度子痫前期孕妇的出血性肝梗死:病例报告

Hemorrhagic hepatic infarction in a pregnant woman with severe pre-eclampsia: a case report.

作者信息

Onanga Antoine O, Narayan Gaurang, Rusho Maher A, Kalala Brigitte, Bwami Clovis A, Karanga Edouard K, Bulondo Daniel, Peter Uggh Innocent H, Naaz Farheen, Suheb Mahammed K, Tague Christian, Akilimali Aymar

机构信息

Department of Research, Medical Research Circle (MedReC), Bukavu, Democratic Republic of the Congo.

Faculty of Medicine, La Sapientia Catholic University, Goma, Democratic Republic of the Congo.

出版信息

Ann Med Surg (Lond). 2024 Oct 16;86(12):7338-7342. doi: 10.1097/MS9.0000000000002617. eCollection 2024 Dec.

Abstract

INTRODUCTION AND IMPORTANCE

Severe pre-eclampsia is a medical condition that affects women during the last two trimesters of pregnancy. Hemorrhagic hepatic infarction is a hepatic complication and is rarely encountered in women with severe pre-eclampsia. This case report aims to present the characteristics of hemorrhagic hepatic infarction in a pregnant woman with severe pre-eclampsia.

CASE PRESENTATION

A 27-year-old pregnant woman with a 30-week gestation of amenorrhea was admitted with a blood pressure of 160/100 millimeters of Mercury (mmHg), headaches, dizziness, and oedema in the lower limbs.

CLINICAL DISCUSSION

These complaints with clinical and paraclinical examinations led to the diagnosis of severe pre-eclampsia, and she underwent an emergency cesarean section, but 6 h later, she presented with hypovolemic shock, and this led to a new surgery. A surgery that made it possible to develop or discover a diffuse hepatic infarction with hemorrhagic infiltration of the gallbladder and the falciform ligament without active bleeding in the liver. Emergency management of pre-eclampsia was adopted, and the postoperative course was simple, with a good clinical outcome when the patient was discharged.

CONCLUSION

Severe pre-eclampsia and hemorrhagic hepatic infarction are complications of pregnancy, which require emergency treatment, and above all, these medical conditions require the termination of the pregnancy.

摘要

引言与重要性

重度子痫前期是一种在妊娠晚期影响女性的病症。出血性肝梗死是一种肝脏并发症,在重度子痫前期女性中很少见。本病例报告旨在呈现一名重度子痫前期孕妇的出血性肝梗死特征。

病例介绍

一名停经30周的27岁孕妇因血压160/100毫米汞柱(mmHg)、头痛、头晕及下肢水肿入院。

临床讨论

这些症状经临床及辅助检查后诊断为重度子痫前期,她接受了急诊剖宫产,但6小时后出现低血容量性休克,这导致了再次手术。此次手术发现了弥漫性肝梗死,伴有胆囊及镰状韧带的出血性浸润,肝脏无活动性出血。采取了子痫前期的紧急处理措施,术后病程顺利,患者出院时临床结局良好。

结论

重度子痫前期和出血性肝梗死是妊娠并发症,需要紧急治疗,最重要的是,这些病症需要终止妊娠。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d431/11623903/abe1ef642a29/ms9-86-7338-g001.jpg

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