Razavi Journal of Medicine

Razavi Journal of Medicine

A Rare Case of Spontaneous Hepatic Rupture Secondary to a Solitary Necrotic Nodule of the Liver in a Pregnant Woman; Never Put off the Action Until Tomorrow

Document Type : Case Report/Series

Authors
1 Department of Obstetrics and Gynecology, Razavi Hospital, Imam Reza International University, Mashhad, Iran
2 Department of Anesthesiology, Razavi Hospital, Imam Reza International University, Iran
3 Department of Anesthesiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
4 Department of Obstetrics and Gynecology, Maternity Division, Gloucester Royal Hospital, Gloucester, United Kingdom
Abstract
Background: Spontaneous hepatic rupture (SHR) in pregnancy is a rare and life-threatening event that causes a high burden of maternal and perinatal mortality. Herein, we describe a pregnant woman with a perplexing manifestation that results in maternal mortality followed by SHR.
 
Case Presentation: A 37-year-old woman at 38 weeks of gestational age, complaining of continuous and worsening epigastric pain with intermittent vomiting, was admitted to the emergency department. Regarding the abdominal pain's unexplained nature, some paraclinical findings, such as deceleration in fetal heart rate and breech presentation, led to the emergent cesarean section being scheduled. After the baby's birth, a massive hemorrhage originating from the Glisson capsule, hepatic right lobe, and the partial section of the left hepatic lobe were seen. Unfortunately, the surgical intervention can not manage the patient at the end of the surgery.
 
Conclusion: The multidisciplinary approach and aggressive intervention of SHR patients may heighten the chance of survival, especially in pregnant women.
Keywords

Acknowledgements: We are very grateful to all the department of meternity block and pathology staff, Razavi hospital, Mashhad, Iran.

 

Availability of data and materials: The dataset presented in the study is available on request from the corresponding author during submission or after publication.

 

Conflicts of interests: The authors declare no conflict of interest.

 

Consent for publication: Written informed consent was obtained from the patient's guardians to publish.

 

Ethics approval and consent to participate: Written informed consent was obtained from the patient's guardians to publish. Also, this study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki

 

Financial disclosure: No financial support was received for this study.

 

Author contributions: S.N.: Contributed to the conception of the work, revising the draft, approving the final version of the manuscript, and agreeing on all aspects of the work; A. S. B: Contributed to acquiring data, drafting the manuscript, and approving the final version; G. K. and B.F.: Contributed to the conception and design of the study, critical revision, and approval of the manuscript's final version; Sh. S., Contributed to the conception and design of the study, drafting of the manuscript, critical revision, and approval of the final version.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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