Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A case of delayed hemorrhage of a subcapsular liver hematoma in a neonate

신생아에서 발생한 대량 피막하 간 혈종의 지연성 파열 1례

  • Moon, Soo Kyoung (Department of Pediatrics, School of Medicine, Eulji University) ;
  • Lee, Tae Suk (Department of Surgery, School of Medicine, Eulji University) ;
  • Yoon, Hye Sun (Department of Pediatrics, School of Medicine, Eulji University)
  • 문수경 (을지대학교 의과대학 소아과학교실) ;
  • 이태석 (을지대학교 의과대학 외과학교실) ;
  • 윤혜선 (을지대학교 의과대학 소아과학교실)
  • Received : 2007.09.03
  • Accepted : 2007.10.10
  • Published : 2008.01.15
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Abstract

A subcapsular liver hematoma (SLH) is a relatively common lesion in fetuses and neonates. Although an SLH ruptures rarely, it may be life threatening. We report on a term neonate with a delayed rupture of an SLH that occurred on day 7 of life. The infant had been resuscitated with intubation, positive pressure ventilation, and chest compression at birth because of meconium-associated perinatal depression. The SLH was diagnosed by abdominal ultrasonography and paracentesis, and the ruptured SLH was treated operatively. After intensive medical and surgical management, the infant was discharged healthy on day 27 of life. A newborn infant presenting with the sudden onset of extreme shock and pallor associated with abdominal distension should undergo differential diagnosis for SLH and a clinical evaluation concurrent with fluid resuscitation and timely surgery.

신생아의 피막하 간 혈종은 다양한 원인에 의해서 유발되는데 대부분은 출혈의 양이 적어 임상적으로 발견되기 보다는 부검시 발견되는 경우가 많다. 그러나 출혈의 양이 많아 혈종을 싸고 있는 피막이 파열되고 잇따른 출혈이 발생할 경우에는 창백, 혈관 허탈, 빈혈, 복부팽만, 저산소증, 산혈증 등의 증상을 보이므로 조기에 의심하여 정확한 진단을 내리고 적절한 수술적 치료를 실시하지 않으면 사망률이 높다. 저자들은 태변 흡입후 신생아 가사 소견을 보여 심폐소생술을 실시한 신생아에서 출생후 7일에 발현된 대량 피막하 간 혈종 파열 1례를 경험하였기에 보고하는 바이다.

Keywords

References

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