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Case Reports
. 2019 Aug;40(8):836-839.
doi: 10.15537/smj.2019.8.24376.

Unexpected extensive hemorrhage from a subcapsular hematoma of the liver during emergent laparotomy in a premature neonate

Jeong H Park  1 , Wonho Cho, Min A Kwon
Affiliations
Case Reports

Unexpected extensive hemorrhage from a subcapsular hematoma of the liver during emergent laparotomy in a premature neonate

Jeong H Park et al. Saudi Med J. 2019 Aug.

Abstract

A subcapsular hematoma of the liver is often found during autopsy in stillborn infants rather than clinically. It is usually asymptomatic unless ruptured; thus, the diagnosis is often delayed or missed. Rupture of a subcapsular hematoma in a premature neonate causes massive intraabdominal hemorrhage, which is associated with high mortality. Thus, early recognition and treatment to avoid rupture are imperative. We describe a case of life-threatening hemorrhage from a subcapsular hematoma of the liver during emergent laparotomy for mechanical obstruction in an 860 g premature neonate and discuss the appropriate preoperative preparation and anesthetic management for this case.

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Figures

Figure 1
Figure 1
Patient’s flow chart of clinical feature. NICU - neonatal intensive care unit. CPR - cardiopulmonary resuscitation
Figure 2
Figure 2
Preoperative abdominal sonography showed a subcapsular liver hematoma of 1.1 cm x 0.5 cm.
See this image and copyright information in PMC

References

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