Multidisciplinary management of the pregnant patient in haemorrhagic shock secondary to an undiagnosed ruptured liver adenoma

Brittany Sanford, Catherine Hoeppner, Tammy Ju, Brian K. Theisen, Anna Buabbud, Jordan M. Estroff

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Abstract

Management of a ruptured hepatocellular adenoma during pregnancy is a rare and potentially life-threatening entity. Few case reports have described management of the pregnant patient who presents in haemorrhagic shock secondary to a ruptured liver adenoma. A 30-year-old primigravid woman at 31 weeks pregnant presented with abdominal pain and fetal bradycardia. After stat caesarean delivery of the infant, she had continued hemoperitoneum and was in shock secondary to an undiagnosed ruptured liver mass. General surgery was consulted intraoperatively and performed an exploratory laparotomy, packing and temporary closure. She was subsequently taken to interventional radiology (IR) for angioembolisation of the left hepatic artery. After stabilisation, she underwent formal abdominal closure. Management of a ruptured hepatocellular adenoma in pregnancy requires urgent multidisciplinary care including obstetrics gynaecology, general surgery and IR.

Original languageEnglish (US)
Article numbere231995
JournalBMJ case reports
Volume13
Issue number2
DOIs
StatePublished - Feb 13 2020

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Keywords

  • adult intensive care
  • general surgery
  • interventional radiology
  • liver disease
  • pregnancy

ASJC Scopus subject areas

  • Medicine(all)

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