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

نویسندگان

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, Razavi Hospital, Imam Reza International University, Iran

4 Department of Anesthesiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

5 Department of Obstetrics and Gynecology, Maternity Division, Gloucester Royal Hospital, Gloucester, United Kingdom

doi
10.30483/rjm.2025.118614
چکیده

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.