Spontaneous bleeding from liver after open heart surgery

Mir, Najeeb H; Shah, Mian Tahir; Obeid, Mahmoud; Gallo, Ricardo; Aliter, Hashem

doi:10.1016/j.ijscr.2013.05.018

Cited by 2 publications

(2 citation statements)

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“…Free intra-abdominal hemorrhage from a vein near the falciform ligament of the liver and from a bleeding laceration of the splenic capsule occurred on the 2nd postoperative day. More recently, Mir et al [20] reported the case of a 58-year-old male who was admitted for mitral valve repair due to valve regurgitation. A massive sub-capsular hematoma involving both lobes of the liver and active bleeding was diagnosed 8 h postoperatively, though the authors did not find a clear association between anticoagulant medication and intra-hepatic hematoma.…”

Section: Discussionmentioning

confidence: 99%

“…In the case herein described, the hemorrhage within the hepatic cyst induced by the subcutaneous use of nadroparin was likely responsible for the subsequent hepatic hematoma, liver rupture and death. This sequence of events is even more extraordinary considering that spontaneous hemorrhages of simple hepatic cysts rarely occur [20]. Visceral injury following cardiopulmonary resuscitation (external cardiac massage) has been frequently described in the literature, including cardiac, hepatic, splenic, and mesenteric lacerations.…”

Section: Discussionmentioning

confidence: 99%

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Fatal intrahepatic hemorrhage after nadroparin use for total hip arthroplasty

Ventura

Bonsignore

Stefano

et al. 2014

Forensic Sci Med Pathol

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Low-molecular-weight heparins have become the predominant choice for deep venous thrombosis prophylaxis and treatment. However, their use may cause bleeding complications. Intrahepatic bleeding is exceptional and only very few cases have been described. The authors present a unique case of fatal intrahepatic hematoma complicating nadroparin use in a 65-year-old woman with a hepatic cyst who was admitted to hospital for unilateral total hip arthroplasty. At autopsy, hemoperitoneum (2,000 ml of blood and clots) was evident. A ruptured sub-capsular hematoma involving the right lobe of the liver was observed. The hemorrhage within the cyst induced by the nadroparin use was likely responsible for the subsequent hepatic hematoma, liver rupture, and death. This case highlights the need for pathologists and surgeons to be aware of the possibility of intrahepatic hematoma in patients who have received low-molecular-weight heparins, undergone major surgery and present postoperative hemodynamic instability, especially in those with preoperative diagnosis of hepatic cyst.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%