Subcapsular Liver Hematoma Causing Cardiac Tamponade in HELLP Syndrome

Kinthala, Sudhakar; Fakoory, M.; Greaves, T.; Kandamaran, L.; Thomas, H.; Moe, Stephen

doi:10.1097/01.aoa.0000432400.22335.56

Cited by 2 publications

(3 citation statements)

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“…Specifically, we address the timely evaluation, resuscitation, and ongoing management necessary to reduce the morbidity and mortality of this condition. Our review of the literature suggests that while asymptomatic pericardial effusions may occur in late pregnancy, there are only 13 case reports of peripartum cardiac tamponade [5][6][7][8][9][10][11][12][13][14][15][16][17] . Reported etiologies are diverse and include autoimmune, infectious, neoplastic, and iatrogenic causes, and all should be considered when encountering a similar patient presentation.…”

Section: Discussionmentioning

confidence: 99%

“…Our review of the literature suggests that while asymptomatic pericardial effusions may occur in late pregnancy, there are only 13 case reports of peripartum cardiac tamponade. [5][6][7][8][9][10][11][12][13][14][15][16][17] Reported etiologies are diverse and include autoimmune, infectious, neoplastic, and iatrogenic causes, and all should be considered when encountering a similar patient presentation. A singular case reported by Matsuki et al was presumed attributable to preeclampsia with severe features as the patient presented with severe hypertension and proteinuria and no other etiology for pericardial effusion was identified.…”

Section: Discussionmentioning

confidence: 99%

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A Rare Case of Obstructive Shock due to Cardiac Tamponade in a Term Pregnancy

Masten,

Kaliounji,

Chou

et al. 2023

AJP Rep

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Background Obstructive shock due to cardiac tamponade is a rare, life-threatening occurrence in the peripartum period. Etiologies include preeclampsia, infection, autoimmune conditions, and malignancy. Early recognition of the underlying disease process allows for multidisciplinary treatment and a favorable outcome. Case A 33 year-old presented for cardiac tamponade identified in the peripartum period. She was diagnosed with preeclampsia with severe features immediately prior to her repeat Cesarean delivery and received magnesium prophylaxis. Postoperatively, she developed hypotension, tachycardia, and shortness of breath and was found to have a pericardial effusion with tamponade physiology. She underwent pericardial drain placement which was initially successful. However, she had recurrent symptomatic tamponade and thus a pericardial window was performed resulting in improvement of her symptoms. Workup revealed pericardial inflammation possibly secondary to a viral source, and she was successfully treated with anti-inflammatory therapy. Conclusion We hypothesize that this patient’s cardiac tamponade was caused by inflammatory pericarditis exacerbated by severe preeclampsia. Preeclampsia is a disease characterized by cardiovascular remodeling and fluid shifts in other compartments and thus is theorized to have contributed to this patient’s effusion. Cardiac tamponade should be considered in the differential for any parturient presenting with hypotension and shortness of breath.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Rare Case of Obstructive Shock due to Cardiac Tamponade in a Term Pregnancy

Masten,

Kaliounji,

Chou

et al. 2023

AJP Rep

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“…Enfin, l'échographie abdominopelvienne élimine d'autres causes d'hémorragie du péripartum comme un hématome sous capsulaire du foie ou une rupture spontanée des vaisseaux utéro-ovariens. 10,11 L'échographie est utile dans les situations hémodynamiques complexes. La pré-éclampsie est une situation à risque d'oedème pulmonaire et d'insuffisance rénale.…”

Section: Discussionunclassified

Pré-éclampsie sévère et hémorragie post-partum: apport de l’échographie « corps entier »

Zieleskiewicz

Pierrou

Ragonnet

et al. 2013

Can J Anesth/J Can Anesth

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RésuméObjectif La prise en charge des patientes pré-éclamptiques sévères est un défi pour les équipes travaillant en secteur obstétrical. Nous montrons ici que l'échographie de plusieurs organes du corps réalisée au lit d'une patiente a apporté des informations nécessaires à la prise en charge, sans nécessité de la transférer en service de radiologie ni d'avoir recours à des intervenants extérieurs. É léments cliniques Une patiente pré-éclamptique sévère de 29 ans avec un HELLP syndrome (hémolyse, cytolyse, thrombopénie) développe en post-partum une hémorragie utérine occulte diagnostiquée grâce à une échographie abdomino-pelvienne réalisée au chevet. L'échoguidage a aussi simplifié la mise en place d'un abord veineux central. Cette patiente évolue favorablement après une hystérectomie d'hémostase et l'administration de facteur VII activé. Les échographies pulmonaire et cardiaque ont optimisé la prise en charge hémodynamique non invasive de cette patiente ayant développé un choc hémorragique puis un oedème pulmonaire. L'échocardiographie a guidé le remplissage vasculaire et l'échographie pulmonaire a permis de détecter l'apparition de l'oedème pulmonaire interstitiel et d'en suivre l'évolution. Conclusion Les praticiens doivent être informés de l'intérêt de l'échographie du « corps entier » dans le diagnostic et le traitement de pathologies complexes impliquant plusieurs organes, comme la pré-éclampsie. De plus, l'échographie facilite la prise en charge de l'hémodynamie globale. La formation des anesthésiologistes aux différentes techniques échographiques devrait être encouragée. AbstractPurpose Management of severe pre-eclamptic patients is a challenge for the staff on obstetrical wards. We demonstrate that ultrasound applied to several organs performed at a patient's bedside gave the information required for the patient's management, without the need to transfer her to the radiology department or to call external consultants. Clinical features A 29-yr-old severely pre-eclamptic patient with HELLP syndrome (hemolysis, cytolysis, thrombopenia) presented, in the post-partum period, with an occult uterine hemorrhage diagnosed with bedside abdominal/pelvic ultrasound. Ultrasound was also used to insert a central venous catheter. After undergoing a

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Subcapsular Liver Hematoma Causing Cardiac Tamponade in HELLP Syndrome

Cited by 2 publications

References 0 publications

A Rare Case of Obstructive Shock due to Cardiac Tamponade in a Term Pregnancy

A Rare Case of Obstructive Shock due to Cardiac Tamponade in a Term Pregnancy

Pré-éclampsie sévère et hémorragie post-partum: apport de l’échographie « corps entier »

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