1/22. Spontaneous hepatic rupture in pregnancy.The HELLP-syndrome (haemolysis, elevated liver enzymes, low platelets) is associated with pre-eclampsia and may cause subcapsular liver haematomas. When hepatic rupture occurs the mortality of mother and unborn is high. rupture remains a surgical emergency with control of bleeding based on trauma principles. We report a case and discuss the diagnosis and management.- - - - - - - - - - ranking = 1keywords = haematoma (Clic here for more details about this article) |
2/22. Intra-hepatic haematoma complicating transjugular intra-hepatic portosystemic shunt for budd-chiari syndrome associated with anti-phospholipid antibodies, aplastic anaemia and chronic hepatitis c.Portal venous decompression with transjugular intra-hepatic portosystemic shunt (TIPS) is a new approach in the treatment of budd-chiari syndrome. We report on a 31-year-old female with budd-chiari syndrome due to anti-phospholipid antibodies with compression of the inferior vena cava treated with TIPS and stenting of the inferior vena cava. TIPS was complicated by massive intra-hepatic haematoma which was managed conservatively. Treatment options and pathogenic mechanisms of budd-chiari syndrome under the rare coincidence of aplastic anaemia and anti-phospholipid syndrome are discussed. TIPS may be considered for venous decompression in budd-chiari syndrome, but physicians should be aware of potential TIPS' complications in these patients.- - - - - - - - - - ranking = 5keywords = haematoma (Clic here for more details about this article) |
3/22. Postpartum follow-up of hepatic calcification detected by prenatal ultrasound.The causes of parenchymal hepatic calcification are mostly transplacental infection of TORCH complex, ischaemic necrosis, or tumours of foetal liver including haemangioma, hamartoma, teratoma, hepatoma, and hemangioendothelioma. Vascular pathologies like hepatic artery aneurysm, haematoma, calcified thromboemboli of portal vein and hepatic veins can also cause hepatic calcification. We present a case of hepatic calcification which was first diagnosed by prenatal ultrasound. In the postpartum follow-up, we observed that the calcifications had decreased in number and size. The causes and results of hepatic calcification or underlying disease are discussed with analysis of the literature.- - - - - - - - - - ranking = 1keywords = haematoma (Clic here for more details about this article) |
4/22. rupture of subcapsular haematoma of the liver in a case of eclampsia.A case of rupture of subcapsular haematoma of the liver in a patient suffering from eclampsia is reported in which the patient survived. Peritoneal tap provided important diagnostic information. Surgical intervention with control of the liver haemorrhage provides the only chance of survival.- - - - - - - - - - ranking = 5keywords = haematoma (Clic here for more details about this article) |
5/22. Haemorrhagic hepatic cyst: a differential diagnosis of cystic tumour.A 63-year-old man was found on ultrasound examination to have a hepatic cystic mass with a mural nodule, which was mildly enhanced on contrast enhanced CT and MRI. At surgery, the cystic fluid was haemorrhagic and histological examination of the mural nodule demonstrated an organized haematoma. This case is of interest in that an apparent mural nodule was present in a non-neoplastic cyst. Haemorrhagic hepatic cyst with an organized haematoma should be included in the differential diagnosis of cystic neoplasms.- - - - - - - - - - ranking = 2keywords = haematoma (Clic here for more details about this article) |
6/22. Fatal hepatic haemorrhage in a child-peliosis hepatis versus maltreatment.A 2.5-year-old boy with known myotubular myopathy (Spiro-Shy-Gonatas syndrome) and gonadorelin intake 9 months ante-mortem was found dead in his bed at home. At autopsy a ruptured subcapsular haematoma of the liver with resulting haemoperitoneum (600 ml) was found. Both lobes of the liver showed numerous circular blood foci <1 mm-2 cm in diameter. Signs of mechanical trauma such as bruising of the abdominal wall were absent. Histologically, the blood cysts were commonly connected to the sinusoids but did not have an endothelial lining and the reticular fibres showed ruptures. These pathomorphological findings are characteristic for peliosis hepatis and the cause of death was therefore determined to be exsanguination due to hepatic haemorrhage from peliosis hepatis instead of from mechanical trauma. To our knowledge this is the youngest casualty from peliosis reported so far.- - - - - - - - - - ranking = 1keywords = haematoma (Clic here for more details about this article) |
7/22. survival following amniotic fluid embolism and cardiac arrest complicated by sub-capsular liver haematoma.We describe the anaesthetic and intensive care management of a 38-year-old mother with presumed amniotic fluid embolism who suffered cardiorespiratory collapse following delivery of a normal baby by caesarean section. After initial resuscitation, her recovery was complicated by development of disseminated intravascular coagulation and a large sub-capsular hepatic haematoma. We describe the initial resuscitative efforts and subsequent intensive therapy to full neurological recovery and discharge from hospital.- - - - - - - - - - ranking = 5keywords = haematoma (Clic here for more details about this article) |
8/22. Subcapsular hematoma of the liver after laparoscopic cholecystectomy.Two female patients underwent an uneventful laparoscopic chloecystectomy (LC) for cholelithiasis. Their past medical history was insignificant. The first patient had diclofenac sodium for her postoperative pain relief. Both patients returned in the early postoperative period with pain in the right hypochondrium. Laboratory investigations revealed elevated leucocytes, C reactive protein (CRP), and deranged liver function tests. A computed tomography (CT) scan showed subcapsular haematoma of liver. CT-guided aspiration of hematoma was done in one case. Both patients improved over a period of time and a follow-up radiological scan showed resolving hematoma. The presentation, diagnostic evaluation, treatment, and possible causes are discussed.- - - - - - - - - - ranking = 1keywords = haematoma (Clic here for more details about this article) |
9/22. Spontaneous rupture of the liver following a normal pregnancy and delivery.Liver haematoma and rupture is a rare but potentially devastating complication of pregnancy. The majority of cases are associated with severe preeclampsia. We report a case of spontaneous hepatic rupture in a 39-year old woman following a normal pregnancy and delivery. shoulder tip pain and serum haemoglobin of 6.8 prompted immediate imaging with computed tomography. A large subcapsular haematoma involving the right lobe of the liver was identified and managed conservatively. This diagnosis should be considered in the patient who presents with pain in the upper part of the abdomen and signs of haemorrhagic shock, even in the case of an uncomplicated pregnancy.- - - - - - - - - - ranking = 2keywords = haematoma (Clic here for more details about this article) |
10/22. hellp syndrome and subcapsular liver haematoma.hellp syndrome is a disease of variable presentation with high mortality and morbidity. Haemolysis in hellp syndrome is microangiopathic. Obstruction of hepatic blood flow by fibrin deposits in sinusoids results in elevated liver enzymes. It also leads to periportal necrosis and, in severe cases, intrahepatic haemorrhage, subcapsular haematoma formation or hepatic rupture. This case report describes a patient presenting with mild hypertension with abruptio-placentae. She developed hellp syndrome, subcapsular liver haematoma and pleural effusion after delivery.- - - - - - - - - - ranking = 6keywords = haematoma (Clic here for more details about this article) |
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