J Korean Soc Radiol.  2010 Jul;63(1):29-32. 10.3348/jksr.2010.63.1.29.

Spontaneous Hepatic Rupture Associated with Preeclampsia: Treatment with Hepatic Artery Embolization

• Yang SB
• Goo DE
• Chang YW
• Kim YJ
• Hwang IC
• Han HS
• Yoon JH
• Lee TI

• KMID: 2208882
• DOI: http://doi.org/10.3348/jksr.2010.63.1.29

Abstract

Spontaneous rupture of the liver due to preeclampsia is a rare condition of pregnant women, and it can be very dangerous if not treated. We report here on a case of successfully treating spontaneous liver rupture associated with preeclampsia by performing transcatheter hepatic arterial embolization. A 41-year-old woman with spontaneous rupture of the liver associated with preeclampsia was treated by hepatic arterial embolization.

MeSH Terms

Adult
Female
Hepatic Artery
Humans
Liver
Liver Diseases
Pre-Eclampsia
Pregnancy Complications
Pregnant Women
Rupture
Rupture, Spontaneous

Figure

• 

  Fig. 1 A 41-year-old woman with hepatic rupture associated with preeclampsia. A, B. The computed tomography scan through the liver with intravenous contrast enhancement on the first postpartum day. A poorly circumscribed low density area in the both lobes of the liver with a large amount of subcapsular hematoma. C, D. The hepatic arteriogram shows displacement of hepatic vessels due to a large subcapsular hematoma with multiple small pseudoaneurysms (arrows) in both lobes. E. The post embolization hepatic arteriogram showing that both the lobar hepatic arteries are occluded. F. The computed tomography scan 10 days after embolization shows a large amount of subcapsular hematoma of the liver. G. The ultrasongraphy scan shows the barely visible subcapsular hematoma of the liver.

Reference

1. Hibbard LT. Spontaneous rupture of the liver in pregnancy: report of eight cases. Am J Obstet Gynecol. 1976; 126:334–338.

2. Bis KA, Waxman B. Rupture of the liver associated with pregnancy: a review of the literature and report of 2 cases. Obstet Gynecol Surv. 1976; 31:763–773.

3. Gyang AN, Srivastava G, Asaad K. Liver capsule rupture in eclampsia: treatment with hepatic artery embolisation. Arch Gynecol Obstet. 2006; 274:377–379.

4. Rolfes DB, Ishak KG. Liver disease in toxemia of pregnancy. Am J Gastroenterol. 1986; 81:1138–1144.

5. Killam AP, Dillard SH, Patton RC, Pederson PR. Pregnancy-induced hypertension complicated by acute liver disease and disseminated intravascular coagulation. Am J Obstet Gynecol. 1975; 123:823–828.

6. McKay DG. Hematologic evidence of disseminated intravascular coagulation in eclampsis. Obstet Gynecol Surv. 1972; 27:399–417.

7. Wagner WH, Lundell CJ, Donovan AJ. Percutaneous angiographic embolization for hepatic hemorrhage. Arch Surg. 1985; 120:1241–1249.

8. Hirai K, Kawazoe Y, Yamashita K, Kumagai M, Nagata K, Kawaguchi S, et al. Transcatheter arterial embolization for spontaneous rupture of hepatocelluar carcinoma. Am J Gastroenterol. 1986; 81:275–279.

9. Chuang VP, Wallace S. Hepatic artery embolization in the treatment of hepatic neoplasm. Radiology. 1981; 140:51–58.

10. Terasaki KK, Guinn MF, Lundell CJ, Finck EJ, Pentecost MJ. Spontaneous hepatic hemorrhage in preeclampsis: treatment with hepatic arterial embolization. Radiology. 1990; 174:1039–1041.

11. Loevinger EH, Vujic I, Lee WM, Anderson M. Hepatic rupture associated with pregnancy: treatment with transcatheter emobolotherapy. Obstet Gynecol. 1985; 65:281–284.