Yotsumoto G, Tanaka K, Ishizaki N, Ikoma A, Kawashima S, Taira A
Second Department of Surgery, Faculty of Medicine, Kagoshima University, Japan.
Surg Today. 1997;27(7):657-60. doi: 10.1007/BF02388225.
We report herein a case of spontaneous subcapsular hepatic hemorrhage which occurred in a 33-year-old woman 1 day after she had been delivered of her second child by cesarean section following an uneventful pregnancy. She complained of right upper quadrant pain on the 1st postoperative day, and computed tomography (CT) showed subcapsular low-density masses in both liver lobes, while extravasation was demonstrated by CO2 intraarterial digital subtraction angiography (IADSA). The hemorrhage was successfully controlled by transcatheter arterial embolization (TAE). However, on the 3rd day after TAE, an exploratory laparotomy was performed to establish an exact diagnosis to explain the persistent abdominal pain and abnormal liver function tests. Subcapsular hematomas in both lobes were confirmed and no visible laceration was present. The patient recovered gradually by spontaneous absorption of the hematomas and was discharged on the 22nd postoperative day. Spontaneous hepatic hemorrhage associated with pregnancy is a very rare complication, and establishing a correct diagnosis and initiating appropriate therapy are essential for this life-threatening disease.
我们在此报告一例自发性肝包膜下出血病例，该病例发生在一名33岁女性身上，她在经历了一次顺利的妊娠后，剖宫产下第二个孩子1天后出现此情况。术后第1天，她主诉右上腹疼痛，计算机断层扫描（CT）显示两个肝叶均有包膜下低密度肿块，而二氧化碳动脉数字减影血管造影（IADSA）显示有造影剂外渗。经导管动脉栓塞术（TAE）成功控制了出血。然而，在TAE术后第3天，进行了剖腹探查术以明确诊断，解释持续的腹痛和肝功能检查异常。确认两个肝叶均有包膜下血肿，且未见明显裂伤。患者通过血肿的自发吸收逐渐康复，并于术后第22天出院。与妊娠相关的自发性肝出血是一种非常罕见的并发症，对于这种危及生命的疾病，做出正确诊断并启动适当治疗至关重要。
