Non-traumatic hepatic hemorrhage: An eventful first presentation in young females

Abstract text (incl. references and figure legends)

Introduction:

Spontaneous liver hemorrhage (SLH) causing a significant hemoperitoneum is a rare and potentially life-threatening condition. SHL that can be associated either with benign or malignant liver disorders.

Being the diagnosis and management difficult, it contributes to a high mortality rate. It is unclear what the standard of care is at present.

Case history:

We report a case of a 32 year-old female patient, without a relevant past medical history other than oral contraceptive agents, who was admitted to the Emergency Department with epigastric and left upper quadrant abdominal pain. On admission, the patient was hemodynamically stable and blood tests revealed haemoblobin 12.4g/dL and slight elevation of inflamatory markers.

An abdomino-pelvic computerized tomography (CT) scan was performed, showing an epigastric mass (14 x 9,5 cm), of the left liver (segments 2 and 3), with an extensive hiperdense area compatible with recent hemorrhage but without signs of active bleeding.

The patient was admitted into the intensive care unit for close monitoring. Twenty-four hours after initial admission, Hb levels dropped to 8,9 and although the patient became slightly tachycardic, there were no signs of active hemorrhage on repeated CT scan It was decided by multidisciplinary discussion to program hepatectomy.

The patient was admitted to the operation theatre for a lateral left segmentectomy and was uneventful.

Conclusion:

SLH can quickly become a life-threatening situation.

Surgeons must be aware of this disease, as well as the available armamentarium in order to address these cases.

Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.)

No