Liver laceration and hemoperitoneum in a premature neonate: a rare case of perinatal trauma

We present a case of a premature very low birth weight neonate who developed abdominal distension and acute anemia on his 2nd day of life, in which a liver laceration was diagnosed. Neonatal hepatic injury is rare but frequently fatal. It usually happens due to perinatal trauma in complicated labor...

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Autores principales:	Joana Marques, Olga Voutsen, Sérgio Ferreira, Rosalina Barroso
Formato:	article
Lenguaje:	EN IT
Publicado:	Hygeia Press di Corridori Marinella 2021
Materias:	liver injury laceration hemoperitoneum perinatal trauma Medicine R Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/bc8eb8f35b544e7bb298319388055ead
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spelling	oai:doaj.org-article:bc8eb8f35b544e7bb298319388055ead2021-11-26T19:58:49ZLiver laceration and hemoperitoneum in a premature neonate: a rare case of perinatal trauma2281-069210.7363/110126https://doaj.org/article/bc8eb8f35b544e7bb298319388055ead2021-11-01T00:00:00Zhttps://jpnim.com/index.php/jpnim/article/view/1099https://doaj.org/toc/2281-0692We present a case of a premature very low birth weight neonate who developed abdominal distension and acute anemia on his 2nd day of life, in which a liver laceration was diagnosed. Neonatal hepatic injury is rare but frequently fatal. It usually happens due to perinatal trauma in complicated labor or delivery or when resuscitation maneuvers take place. It can result in a subcapsular hematoma of the liver but can also translate as a simple laceration. When the hepatic capsule ruptures, a hemoperitoneum usually develops. Umbilical vein catheterization, hepatic congestion and an increased bleeding tendency have also been associated with liver injury and hemorrhaging in the neonate. Clinical presentation can vary from abdominal distension to acute anemia or even hemorrhagic shock. Unspecific signs such as lethargy, tachypnea, feeding intolerance, jaundice and laboratory findings of thrombocytopenia, coagulation disturbances and hyperbilirubinemia can occur. Diagnosis may be difficult, and imaging methods are essential. A conservative approach to treatment is usually preferred, even in the case of a hemoperitoneum. In the case described, there was a history of a difficult extraction and need for resuscitation maneuvers at birth. The abdominal radiograph showed a large liver, and ultrasound revealed a hepatic laceration and a hemoperitoneum. Treatment was supportive, consisting of blood components, expectant observation and strict avoidance of abdominal manipulation. Follow-up of the lesion through serial ultrasounds was performed, and the infant survived, recovering well. This case is one of the few in recent literature describing a good outcome in neonatal liver injury. Awareness of the possibility of its occurrence is important, especially in premature neonates, who are at particular risk.Joana MarquesOlga VoutsenSérgio FerreiraRosalina BarrosoHygeia Press di Corridori Marinellaarticleliver injurylacerationhemoperitoneumperinatal traumaMedicineRPediatricsRJ1-570ENITJournal of Pediatric and Neonatal Individualized Medicine, Vol 11, Iss 1, Pp e110126-e110126 (2021)
institution	DOAJ
collection	DOAJ
language	EN IT
topic	liver injury laceration hemoperitoneum perinatal trauma Medicine R Pediatrics RJ1-570
spellingShingle	liver injury laceration hemoperitoneum perinatal trauma Medicine R Pediatrics RJ1-570 Joana Marques Olga Voutsen Sérgio Ferreira Rosalina Barroso Liver laceration and hemoperitoneum in a premature neonate: a rare case of perinatal trauma
description	We present a case of a premature very low birth weight neonate who developed abdominal distension and acute anemia on his 2nd day of life, in which a liver laceration was diagnosed. Neonatal hepatic injury is rare but frequently fatal. It usually happens due to perinatal trauma in complicated labor or delivery or when resuscitation maneuvers take place. It can result in a subcapsular hematoma of the liver but can also translate as a simple laceration. When the hepatic capsule ruptures, a hemoperitoneum usually develops. Umbilical vein catheterization, hepatic congestion and an increased bleeding tendency have also been associated with liver injury and hemorrhaging in the neonate. Clinical presentation can vary from abdominal distension to acute anemia or even hemorrhagic shock. Unspecific signs such as lethargy, tachypnea, feeding intolerance, jaundice and laboratory findings of thrombocytopenia, coagulation disturbances and hyperbilirubinemia can occur. Diagnosis may be difficult, and imaging methods are essential. A conservative approach to treatment is usually preferred, even in the case of a hemoperitoneum. In the case described, there was a history of a difficult extraction and need for resuscitation maneuvers at birth. The abdominal radiograph showed a large liver, and ultrasound revealed a hepatic laceration and a hemoperitoneum. Treatment was supportive, consisting of blood components, expectant observation and strict avoidance of abdominal manipulation. Follow-up of the lesion through serial ultrasounds was performed, and the infant survived, recovering well. This case is one of the few in recent literature describing a good outcome in neonatal liver injury. Awareness of the possibility of its occurrence is important, especially in premature neonates, who are at particular risk.
format	article
author	Joana Marques Olga Voutsen Sérgio Ferreira Rosalina Barroso
author_facet	Joana Marques Olga Voutsen Sérgio Ferreira Rosalina Barroso
author_sort	Joana Marques
title	Liver laceration and hemoperitoneum in a premature neonate: a rare case of perinatal trauma
title_short	Liver laceration and hemoperitoneum in a premature neonate: a rare case of perinatal trauma
title_full	Liver laceration and hemoperitoneum in a premature neonate: a rare case of perinatal trauma
title_fullStr	Liver laceration and hemoperitoneum in a premature neonate: a rare case of perinatal trauma
title_full_unstemmed	Liver laceration and hemoperitoneum in a premature neonate: a rare case of perinatal trauma
title_sort	liver laceration and hemoperitoneum in a premature neonate: a rare case of perinatal trauma
publisher	Hygeia Press di Corridori Marinella
publishDate	2021
url	https://doaj.org/article/bc8eb8f35b544e7bb298319388055ead
work_keys_str_mv	AT joanamarques liverlacerationandhemoperitoneuminaprematureneonateararecaseofperinataltrauma AT olgavoutsen liverlacerationandhemoperitoneuminaprematureneonateararecaseofperinataltrauma AT sergioferreira liverlacerationandhemoperitoneuminaprematureneonateararecaseofperinataltrauma AT rosalinabarroso liverlacerationandhemoperitoneuminaprematureneonateararecaseofperinataltrauma
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Liver laceration and hemoperitoneum in a premature neonate: a rare case of perinatal trauma

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