Spontaneous liver hematoma and a hepatic rupture in HELLP syndrome:: Report of two cases
Spontaneous liver hematoma and a hepatic rupture in HELLP syndrome:: Report of two cases
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DOI：
10.1007/s005950200074
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发表时间：
2002-01-01
期刊：
影响因子：
2.5
通讯作者：
Keles, C
中科院分区：
文献类型：
--
作者：
Aldemir, M;Baç, B;Keles, C
肝包膜下血肿和破裂是溶血的罕见致命并发症。肝酶升高。低血小板综合征（HS）。我们提出两例自发性破裂的肝包膜下血肿发生在HS和回顾这方面的文献。一个病例显示继发性肝包膜下血肿破裂由于HS在一个病人和HS与先兆子痫在另一个。1例患者的缺损位于左叶的中叶和外侧，另1例患者位于右叶的内侧。1例进行深床垫缝合和网膜成形术。在另一种情况下，有缺陷的区域用具有止血作用的可吸收明胶海绵封闭。此外，腹部毛巾压迫肝脏。高度怀疑和立即识别是正确诊断和管理受影响患者的关键。多学科的方法来管理这些病人导致死亡率显著下降。对于这类凝血病患者，较低侵袭性的治疗比肝切除术等侵袭性干预更可取。
Subcapsular liver hematomas and ruptures are unusual fatal complications of HELLP (hemolysis. elevated liver enzymes. and low platelets) syndrome (HS). We present two cases of a spontaneous rupture of subcapsular liver hematoma occurring in HS and review the literature on this subjects. One case demonstrated a secondary rupture of a subcapsulary liver hematoma due to HS in one patient and HS associated with preeclampsia in another. The defects were on the media] and lateral sectors of the left lobe in one patient and on the medial sector of the right lobe in the other patient. In case 1 deep mattress sutures and omentoplasty were performed. and in the other case a defective area was closed with an absorbable gelatin sponge with a hemostatic effect. In addition, the liver was compressed by abdominal towels. A high index of suspicion and immediate recognition are keys to proper diagnosis and management of affected patients. The multidisciplinary approach to the management of these patients led to a remark-able decrease in the mortality rates. Less aggressive treatment is preferable to aggressive intervention such as a hepatic resection in such patients with coagulopathy.