Spontaneous liver rupture following SARS-CoV-2 infection in late pregnancy: A case report.
World J Clin Cases
; 10(15): 5042-5050, 2022 May 26.
Article
in English
| MEDLINE | ID: covidwho-1884759
ABSTRACT
BACKGROUND:
Coronavirus disease-2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by systemic inflammatory response syndrome and vasculopathy. SARS-CoV-2 associated mortality ranges from 2% to 6%. Liver dysfunction was observed in 14%-53% of COVID-19 cases, especially in moderate severe cases. However, no cases of spontaneous hepatic rupture in pregnant women with SARS-CoV-2 have been reported. CASESUMMARY:
A 32-year-old pregnant patient (gestational age 32 wk + 4 d) without any remarkable medical history or long-term medication presented with epigastralgia. Infectious, non-infectious, and pregnancy-related hepatopathies were excluded. Sudden onset of right subcostal pain with D-dimer and liver enzyme elevation was followed by shock with thrombocytopenia. While performing an emergency cesarean section, hemoperitoneum was observed, and the patient delivered a stillbirth. A 6-cm liver rupture at the edges of segments V and VI had occurred, which was sutured and drained. SARS-CoV-2 positivity on reverse transcription-polymerase chain reaction was confirmed. Further revisions for intrahepatic hematoma with hemorrhagic shock and abdominal compartment syndrome were performed. Subsequently, the patient developed hemoptysis, which was treated using bronchoscopic therapy and non-invasive ventilation. Liver tissue biopsy revealed hemorrhagic foci and necrosis with an irregular centrilobular distribution. Antiphospholipid syndrome and autoimmune hepatitis were also ruled out. Fetal death was caused by acute intrauterine asphyxia.CONCLUSION:
This case reveals that pregnant women with SARS-CoV-2 infection may be predisposed to liver parenchyma disease with liver rupture.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Case report
/
Prognostic study
Language:
English
Journal:
World J Clin Cases
Year:
2022
Document Type:
Article
Affiliation country:
Wjcc.v10.i15.5042
Similar
MEDLINE
...
LILACS
LIS