American Journal of Case Reports最新文献

{"title":"Management Challenges in Trauma-Induced Coagulopathy: A Case Report of Hemothorax Requiring Reoperation.","authors":"Nozomu Motono, Takaki Mizoguchi, Masahito Ishikawa, Shun Iwai, Yoshihito Iijima, Hidetaka Uramoto","doi":"10.12659/AJCR.944997","DOIUrl":"10.12659/AJCR.944997","url":null,"abstract":"<p><p>BACKGROUND Coagulopathy caused by trauma itself is defined as trauma-induced coagulopathy (TIC). The pathophysiology of TIC is considered to consist of coagulation activation, hyperfibrinolysis, and consumption coagulopathy, similar to disseminated intravascular coagulation (DIC). This report describes a 68-year-old man with a history of epilepsy presenting with TIC associated with multiple traumatic fractures and hemothorax. CASE REPORT A 68-year-old man with a history of epilepsy fell while working on a second-floor roof and had right rib fractures (6th to 12th rib), right hemothorax, right clavicle fracture, right elbow fracture, and pelvic fractures. The right hemothorax became exacerbated and he went into shock. We performed the emergency surgery 5 hours after the trauma. Although circulation dynamics became stable and the discharge of chest drainage became thinned at postoperative day (POD) 1 while administering blood transfusions and tranexamic acid, hemoglobin remained below 8 g/dl, platelet count was below 60 000/µl, and prothrombin time - international normalized ratio (1.22) remained prolonged. Furthermore, the right hemothorax became exacerbated and re-operation was performed on the evening of POD2. Oozing hemorrhages from multiple rib fractures were observed. Although hemostatic management was performed with electrocautery and ultrasound energy devices, the hemorrhage could not be completely managed, so hemostasis was secured using hemostatic materials. CONCLUSIONS The pathophysiologic mechanism of TIC has been emphasized as being different from that of DIC, and management of severe traumatic patients with TIC should be based on an understanding of the pathophysiology of TIC.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e944997"},"PeriodicalIF":1.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Branchial Cleft Anomaly Mimicking Cholesteatoma: A Pediatric Case Study and Surgical Approach.","authors":"Lexi Lin, Jing Bi, Yong Fu","doi":"10.12659/AJCR.945421","DOIUrl":"10.12659/AJCR.945421","url":null,"abstract":"<p><p>BACKGROUND First branchial cleft anomalies (FBCAs) are rare congenital disorders with clinical manifestations and anatomy that are variable and complex. Due to the anatomical proximity to the facial nerve and association with infection, FBCAs require accurate diagnosis and careful management. The purpose of this report was to share the diagnosis and treatment of an extremely rare case of a 4-year-old girl with an FBCA presenting as a painless mass of the left external auditory canal and an inconspicuous depression in the left mandibular angle, a presentation that can easily be misdiagnosed as cholesteatoma of the middle ear. CASE REPORT A 4-year-old girl without any symptoms presented to our department due to \"finding a mass in the left ear canal more than 2 months ago\". Otoscopy, computed tomography, magnetic resonance imaging, and physical examinations supported the diagnosis of FBCA. The patient underwent surgery, which included resection of the first branchial fistula and canalplasty. Intraoperative findings revealed that the facial nerve straddles the fistula surface and that the fistula extends from the bottom oblique to the inferior wall of the external auditory canal. The postoperative diagnosis was \"first branchial cleft fistula (Work type II)\". No facial palsy or recurrence was noted during the follow-up period. CONCLUSIONS This report has highlighted the importance of the correct diagnosis and treatment of FBCAs and awareness of anatomical associations and complications. Careful otologic evaluation can help clinicians make a correct diagnosis. If preoperative examination reveals a connection between the superficial skin and external auditory canal, concurrent canalplasty should be performed.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945421"},"PeriodicalIF":1.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolapsed Epiploica of Colon Presenting as a Vaginal Polyp After Robotic Hysterectomy: A Case Report and Review of the Literature.","authors":"Beena Umar Ahsan, Alexander A Paridon, Arthur R Gaba, Ziying Zhang, Nazila Azordegan","doi":"10.12659/AJCR.944892","DOIUrl":"10.12659/AJCR.944892","url":null,"abstract":"<p><p>BACKGROUND Hysterectomy is a gynecological procedure that can lead to complications arising from structural changes incurred during the surgical process. Vaginal nodules may appear at the vaginal cuff after hysterectomy, which could be indicative of recurring cancer, endometriosis, or formation of fistulae or granulation tissue. In rare instances, abdominal organ prolapse occurs after vaginal cuff dehiscence. Prolapse of the terminal ileum is the most common type of prolapse from vaginal cuff dehiscence, but prolapsed epiploica of colon after hysterectomy occurs in rare instances. Epiploic appendages are a type of fatty tissue attached to the colonic surface that can become inflamed or necrotic and detach from the colon. The purpose of this report is to describe a rare case of prolapsed epiploica of colon at the vaginal cuff. CASE REPORT A 55-year-old woman who had robot-assisted laparoscopic hysterectomy for endometrioid carcinoma presented with a vaginal polyp 2 months after surgery. Histological analysis of the excised polyp revealed adipose tissue with fat necrosis and calcification, indicative of prolapsed epiploica of colon. This is the first report of post-hysterectomy epiploica of colon at the vaginal cuff not associated with obvious dehiscence. CONCLUSIONS This case highlights the importance of thorough histological analysis of excised vaginal nodules and consideration of prolapsed epiploica of colon in the differential diagnoses in addition to benign and malignant vaginal neoplasms.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e944892"},"PeriodicalIF":1.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Surgical Management and Partial Recovery of a 19-Year-Old with Low-Speed Transorbital Penetrating Brain Injury.","authors":"Martin Moïse, Frédérique Depierreux, Laurent Médart","doi":"10.12659/AJCR.943995","DOIUrl":"10.12659/AJCR.943995","url":null,"abstract":"<p><p>BACKGROUND Clinical management of intracranial transorbital penetrating injury (TOPI) is challenging and may require surgery. Both the trauma and surgery can result in neurovascular damage, bleeding, and infection. Low-speed injury may involve the superior orbital fissure (SOF) as the main point of entry into the skull and is associated with lower morbidity than high-speed injuries. This report describes a 19-year-old man with pontine and left cerebellar involvement from a TOPI with partial recovery without surgery. CASE REPORT We hereby report the case of a 19-year-old man who underwent a low-speed in-out (as the foreign body was immediately retrieved) deep transorbital pontine and left cerebellar penetrating injury. Despite transient loss of consciousness, his Glasgow Coma Scale at admission was 15. An intravenous antibiotic regimen was rapidly initiated. He had ophthalmic (V1) et maxillary (V2) nerves palsy, minor right pyramidal syndrome, and left kinetic cerebellar syndrome. Multi-modal imaging perfectly correlated with the clinical presentation. Neither surgical nor angiographic management was required. Clinical evolution was favorable, and the patient partially recovered. CONCLUSIONS In case of penetration through the SOF, the clinical course tends to be benign. However, this case should not overshadow potential life-threatening complications of TOPIs. This report highlights the importance of a multidisciplinary approach for the diagnosis and management of traumatic transorbital penetrating intracranial injury. As illustrated, medical imaging may demonstrate the exact pathway of the offending object.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e943995"},"PeriodicalIF":1.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Graves' Disease and Microcytic Anemia: A Forgotten Connection.","authors":"Fevzi Daldal, Andrew Dancis","doi":"10.12659/AJCR.945836","DOIUrl":"10.12659/AJCR.945836","url":null,"abstract":"<p><p>BACKGROUND Microcytic anemia has long been associated with thyrotoxicosis, but this correlation has been largely forgotten, and few literature references to this phenomenon exist since the 1980s. No mechanism for this association has been proposed. CASE REPORT Here, we present the case of a 56-year-old man who developed clinically significant hyperthyroidism in the setting of Graves' disease and simultaneous microcytic anemia. He was treated with methimazole, and the hyperthyroidism symptoms and biochemical parameters remitted. Simultaneously, the red cell microcytosis and anemia remitted. Notably, iron deficiency as indicated by high serum ferritin was not present during the acute illness, and the ferritin level decreased with methimazole treatment. CONCLUSIONS The supraphysiological concentration of 3,5,3'-triiodo-L-thyronine (T3) gained entry to the cells, bound to hormone receptors (TR), activating a set of responsive genes, via thyroid response elements (TREs). In red cell precursors, which were notably not iron deficient, proteotoxic stress was induced, leading to activation of HRI kinase activity as part of the integrated stress response. The phosphorylation of eIF2 on the critical Ser51 led to depletion of the ternary complex (eIF2-GTP-Met-tRNA) by preventing eIF2 from exchanging GDP for GTP. Formation of the preinitiation complex was hampered, and translation of the abundant globin mRNA was attenuated. Decreased globin synthesis in turn was coupled to smaller red cell size, as occurs in thalassemia.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945836"},"PeriodicalIF":1.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-Modality Imaging in Caseous Calcification of the Mitral Annulus: Case Series and Clinical Implications.","authors":"Emil Dadański, Agnieszka Olszanecka, Danuta Sorysz, Wiktoria Wojciechowska, Bernadeta Chyrchel, Anna Sowa-Staszczak, Andrzej Surdacki, Marek Rajzer","doi":"10.12659/AJCR.944821","DOIUrl":"10.12659/AJCR.944821","url":null,"abstract":"<p><p>BACKGROUND Echogenic masses in the mitral annulus are often incidental findings during routine echocardiography examinations. Most represent the wide spectrum of underlying mitral annular calcifications and usually do not require further diagnostic workup. However, a rare variant called \"caseous calcification of the mitral annulus\" (CCMA) can be challenging to diagnose and often requires an extensive workup with the use of multiple imaging studies in order to accurately confirm the pathology. CASE REPORT The aim of this case series was to illustrate the range of challenges associated with CCMA in various clinical scenarios to highlight the importance of multi-modality imaging in the differential diagnosis. Patient 1 was a 78-year-old asymptomatic woman with a round echo-dense structure incidentally found during a routine echocardiographic examination. Patient 2 was a 79-year-old woman with a suspected mitral abscess. Patient 3 was a 73-year-old woman with an incidentaloma (lung mass), with a concomitant lesion of the mitral annulus. All 3 patients required a unique combination of confirmatory imaging studies to ultimately confirm their diagnosis. CONCLUSIONS The incidental detection of CCMA-like changes requires multi-modality imaging to differentiate from abscesses and proliferative changes in the mitral annulus. Transthoracic echocardiography, transesophageal echocardiography, computed tomography, and cardiac magnetic resonance imaging play a key role in this diagnostic workup. Using a combination of these imaging modalities can enhance diagnostic accuracy and strongly influence the subsequent treatment and management strategies.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e944821"},"PeriodicalIF":1.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malignant Small Bowel Obstruction from Hernia Mesh Invasion by Jejunal Adenocarcinoma: A Report of a Rare Case.","authors":"Grant H McDaniel, Trisha Clark, Joseph Sferra","doi":"10.12659/AJCR.945619","DOIUrl":"10.12659/AJCR.945619","url":null,"abstract":"<p><p>BACKGROUND Small bowel obstructions (SBO) are common and can be caused by various pathologies including intra-abdominal adhesions and hernias. Less frequently, these obstructions are caused by malignancy. The following article will review the etiology and treatment of SBOs, discuss complications of hernia repair with mesh, and examine if there is an association between mesh and cancer. CASE REPORT We present the case of a man who was over 89 years old who presented with an SBO that failed non-operative management. He previously had bilateral inguinal hernia repairs with mesh and pelvic radiation for prostate cancer. Imaging obtained during the workup was concerning for malignancy. Exploratory laparotomy revealed an ascending colon adenocarcinoma and small bowel obstruction secondary to jejunal adenocarcinoma. The jejunal adenocarcinoma was adhered to and invaded into the mesh from a previous hernia repair. He underwent successful resection and anastomosis, had an uneventful postoperative course, and was discharged. Given his advanced age, he refused further workup or treatment. CONCLUSIONS The etiology and management of small bowel obstructions is multifactorial. Small bowel obstructions affect a large portion of the population worldwide and the subsequent management accounts for significant health care spending. This case shows an exceedingly rare and possibly novel case of jejunal adenocarcinoma that invaded into the hernia mesh, leading to a malignant small bowel obstruction. While there is not a clear explanation behind this patients' pathology, we hypothesize that his prior hernia surgery led to an intra-abdominal adhesion, and subsequent pelvic radiation may have facilitated the malignancy invading the mesh and causing a high-grade small bowel obstruction.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945619"},"PeriodicalIF":1.0,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 78-Year-Old Man with Elastofibroma Dorsi Presenting as a Left Subscapular Mass.","authors":"Christoforos S Kosmidis, Konstantinos Vlassopoulos, Chrysi Maria Mystakidou, Vasiliki Theodorou, Alexandros Vasileios Karakousis, Nikolaos Iason Katsios, Fedra Louloudopoulou, Anna Andreadi, Paris Pentousis, Stylianos Mantalovas, Charilaos Koulouris, Konstantinos Farmakis, Nikolaos Varsamis, Stylianos Kosmidis, Marianthi Ntikoudi, Konstantinos Papadopoulos, Leonidas Kougias, Ioannis Chrysogonidis, Isaak Kesisoglou, Ioanna Abba Deka, Georgia Raptou","doi":"10.12659/AJCR.945013","DOIUrl":"10.12659/AJCR.945013","url":null,"abstract":"<p><p>BACKGROUND Elastofibroma dorsi is a rare, benign soft-tissue tumor, emerging in the subscapular area and exhibiting higher prevalence in elderly women. Despite its slow growth rate and asymptomatic nature in most patients, elastofibroma can cause swelling, pain, and discomfort during shoulder movements. Imaging and histopathologic data combined with a detailed history are essential to exclude malignancies and provide suitable treatment. CASE REPORT This report describes the case of a 78-year-old man with an incidental finding of elastofibroma dorsi, presenting as an asymptomatic left subscapular mass. Physical examination revealed the mass, the presence of which was later confirmed through an MRI scan. The tumor was surgically excised without any postoperative complications. Histopathologic findings from a biopsy supported the diagnosis of elastofibroma dorsi, showing an abundance of thick and irregular elastic fibers, giving a \"rope-like\" appearance in hematoxylin and eosin stain. Additionally, Verhoeff-Van Gieson stain highlighted the elastic fibers, making their characteristic arrangement and appearance evident. The patient was then discharged from our hospital and made a complete recovery. CONCLUSIONS Despite its benign nature and rarity, elastofibroma dorsi should be included in the differential diagnosis of subscapular masses. Proper imaging and histopathological examination are crucial for a definitive diagnosis, to ensure that patients receive the appropriate and necessary treatment and guidance. Furthermore, additional research is needed to completely clarify the pathophysiologic mechanism responsible for the development of elastofibroma dorsi.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945013"},"PeriodicalIF":1.0,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11591370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidrug-Resistant Elizabethkingia meningoseptica and Enterococcus faecium Infection in an Oncohematologic Patient.","authors":"Cristina Motta Ferreira, Maria De Nazare Saunier Barbosa, Guilherme Motta Antunes Ferreira, Joseir Saturnino Cristino, Chesman Da Silva Alves, Erasmo Dos Santos Veira, Larissa Alves Gomes, Vander Silva Souza, Franceline Oliveira Calheiros, William Antunes Ferreira","doi":"10.12659/AJCR.945360","DOIUrl":"10.12659/AJCR.945360","url":null,"abstract":"<p><p>BACKGROUND This case report describes a case of a 25-year-old man who underwent a surgical procedure and was subsequently diagnosed with acute myeloid leukemia. Following his immediate admission to a specialized hospital unit for hematology and hemotherapy to receive chemotherapy, he was found to have a concurrent infection with multidrug-resistant Elizabethkingia meningoseptica as well as Enterococcus faecium. Both isolates are commonly associated with healthcare-associated infections. CASE REPORT The patient described in this report underwent an exploratory laparotomy, which is an invasive surgical procedure, and was subsequently diagnosed with acute myeloid leukemia following a biopsy. Chemotherapy was initiated immediately, during which the patient developed clinical signs and symptoms of infection. Blood cultures revealed the presence of Enterococcus faecium, while urine cultures identified Elizabethkingia meningoseptica. The VITEK-2 antibiogram for both bacteria revealed a multidrug resistance profile. E-test performed for glycopeptides indicated high-level resistance, with a minimum inhibitory concentration (MIC) exceeding 256 µg/mL. Prophylactic antibiotic therapy was initiated and subsequently adjusted according to the culture and antibiogram results. CONCLUSIONS Use of proper aseptic techniques during medical procedures is essential. Patients with severely compromised immunity undergoing numerous procedures require strict isolation measures to prevent infections, which can make the difference between life and death. Early laboratory identification of pathogenic clones and their antimicrobial resistance profiles is crucial for timely etiological diagnosis. This helps prevent the spread of infections and hospital infection outbreaks.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945360"},"PeriodicalIF":1.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11591303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subcapsular Liver Hematoma Rupture in HELLP Syndrome During Pregnancy: A Case Study and Multidisciplinary Approach.","authors":"Yingchao Guan, Yejian Zhou, Hongxia Pan, Xueyan Li, Lewen Lin, Songyang Yu, Haifeng Teng, Xiaodong Wang","doi":"10.12659/AJCR.945440","DOIUrl":"10.12659/AJCR.945440","url":null,"abstract":"<p><p>BACKGROUND Spontaneous hepatic hematoma and liver capsule rupture is a rare but severe complication of Hemolysis, Elevated Liver Enzyme, and Low Platelet (HELLP) syndrome, with a high mortality rate. We report a case of a pregnant woman with HELLP syndrome and liver subcapsular hematoma rupture that was diagnosed during surgery. CASE REPORT A 35-year-old woman with 34+1 weeks of pregnancy came to the emergency department due to abdominal pain for 4 days. She was diagnosed with HELLP syndrome after a blood test. She was transferred to the obstetrics department, and an emergency cesarean section was performed under general anesthesia, due to fetal distress. During the surgery, non-clotting blood was found flowing out during the suturing of the incision. We suspended the surgery and organized an emergency multidisciplinary consultation. Subcapsular liver hematoma was diagnosed after intraoperative ultrasound detection. Emergency upper abdominal laparotomy was performed, and a ruptured liver capsule and active bleeding were found. The liver capsule was sutured and blood products were infused before the patient was sent to the intensive care unit. She recovered and was discharged 12 days after surgery. No special discomfort was reported during the 30-day follow-up after surgery. CONCLUSIONS Our case emphasizes that all parturients with abdominal pain and HELLP syndrome must be screened for spontaneous hepatic hematoma, and clinicians should pay attention to whether there is rupture of the liver capsule. Multidisciplinary consultations can increase the probability of successful rescue for such patients.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"25 ","pages":"e945440"},"PeriodicalIF":1.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11591301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}