R Sherbahn1. 1. Department of Obstetrics and Gynecology, Oakwood Hospital, Dearborn, Michigan, USA.
Abstract
BACKGROUND: Spontaneous rupture of a subcapsular liver hematoma in pregnancy is a rare and potentially life-threatening complication of preeclampsia. The incidence is approximately 1 in 45,000 live births. The liver hematoma is often not suspected until it ruptures. CASE: A 32-year-old female developed severe shoulder pain at 33 weeks' gestation while in the hospital with preeclampsia. Liver involvement was suspected, and cesarean delivery was performed. Over the first two postpartum days the patient had rising liver enzyme and falling hematocrit levels. A ruptured subcapsular liver hematoma was discovered at emergency laparotomy. Both mother and infant survived. CONCLUSION: A patient with a liver hematoma will usually experience right upper quadrant or epigastric pain. However, shoulder pain should also be regarded with suspicion in patients with preeclampsia.
BACKGROUND: Spontaneous rupture of a subcapsular liver hematoma in pregnancy is a rare and potentially life-threatening complication of preeclampsia. The incidence is approximately 1 in 45,000 live births. The liver hematoma is often not suspected until it ruptures. CASE: A 32-year-old female developed severe shoulder pain at 33 weeks' gestation while in the hospital with preeclampsia. Liver involvement was suspected, and cesarean delivery was performed. Over the first two postpartum days the patient had rising liver enzyme and falling hematocrit levels. A ruptured subcapsular liver hematoma was discovered at emergency laparotomy. Both mother and infant survived. CONCLUSION: A patient with a liver hematoma will usually experience right upper quadrant or epigastric pain. However, shoulder pain should also be regarded with suspicion in patients with preeclampsia.
Authors: Amin Darrudi; Melody Omrani Nava; Ata Ebrahimi; Kosar Ghaffari; Kasra Ahmadi Moghaddam; Fatemeh Roozbeh Journal: J Family Med Prim Care Date: 2022-05-14