Huang J C, Wang C E, Chu J S, Shih S C, Kao C R, Chou S Y, Jeng C J, Hu Y M, Hsu J C, Liu C B
Department of Internal Medicine, Cheng-Ching General Hospital, Taipei, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1994 Oct;54(4):265-9.
Spontaneous rupture of the liver associated with pregnancy is a rare and grave complication, usually occurring in preeclampsia or eclampsia. Two cases of ruptured subcapsular hematoma of the right liver during pregnancy are reported. The first case was a 19-year-old woman who had suffered from epigastralgia and absent fetal heart beat in the 32nd week of gestation. The second case was a 31-year-old female who complained of nausea and right upper quadrant pain in the 35th week of pregnancy. Both had preeclampsia, and developed shock with disseminated intravascular coagulation soon after admission. Both received surgery and were found to have ruptured hematoma over the right liver. Finally, the first patient died of renal failure, but the second survived because preoperative diagnosis had been exact. Greater suspicion, then awareness of diagnosis can lead to better timing of surgery and an improved prognosis for mother and child.
妊娠合并肝脏自发性破裂是一种罕见且严重的并发症，通常发生在子痫前期或子痫期。本文报告两例妊娠期右肝包膜下血肿破裂病例。第一例为一名19岁女性，在妊娠32周时出现上腹部疼痛且胎心消失。第二例为一名31岁女性，在妊娠35周时出现恶心和右上腹疼痛。两名患者均患有子痫前期，入院后不久均出现休克并伴有弥散性血管内凝血。两人均接受了手术，术中发现右肝有血肿破裂。最终，第一名患者死于肾衰竭，而第二名患者存活，因为术前诊断准确。因此，提高怀疑度进而提高诊断意识可使手术时机更佳，改善母婴预后。
