Nelson E W, Archibald L, Albo D
Am J Surg. 1977 Dec;134(6):817-20. doi: 10.1016/0002-9610(77)90333-6.
Hepatic rupture as a late complication of toxemic pregnancy is a rare yet lethal condition requiring rapid recognition and surgical management. The clinical triad of toxemia, right upper quadrant pain, and sudden hypotension is the diagnostic hallmark of presentation. Most patients present near the time of delivery and are found to have subcapsular hematomas of the right hepatic lobe with free rupture into the peritoneal cavity and resultant exsanguinating hemorrhage. The association of toxemia and disseminated intravascular coagulation with secondary microembolic damage to the liver and other organs has been discussed. Basic surgical principles in the managment of hepatic subcapsular hematomas, and the prolonged postoperative course and frequent complications in these patients have been stressed.
肝破裂作为中毒性妊娠的晚期并发症是一种罕见但致命的疾病，需要迅速识别并进行手术治疗。毒血症、右上腹疼痛和突然低血压这一临床三联征是其典型临床表现。大多数患者在分娩前后发病，被发现右肝叶有包膜下血肿，并伴有包膜破裂进入腹腔，继而发生出血性休克。文中讨论了毒血症与弥散性血管内凝血以及继发的肝脏和其他器官微栓塞损伤之间的关系。强调了处理肝包膜下血肿的基本外科原则，以及这些患者术后病程延长和并发症频发的情况。
