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The authors describe two patients in whom preeclampsia and third trimester miscarriage were associated with hepatic rupture. Abdominal pain and signs of vascular collapse prompted imaging and/or surgery that revealed liver hematoma (treated by drainage and bleeding point control). Epigastric pain, common in preeclampsia. may be due to liver capsule stretching by hematoma or swelling. Liver necrosis may result from hematoma formation. Intraperitoneal rupture usually results in the death of mother and child. The authors suggest ultrasound for diagnosis of liver hematoma if the fetus is alive, and CT and/or angiography postpartum. The authors describe internal pancreatic fistulae in three patients in whom ERCP accurately demonstrated the anatomy for definitive surgical treatment. There were intractable left pleural effusions in two, and ascites in one, with a high amylase in the fluid in all. In Case 1 the fistula was from the tail of pancreas to the left pleura. Case 2 had a pancreatico-gastric-pleural fistula with pancreatic duct ectasia and calculi. Case 3 had a pancreatico-peritoneal fistula with recurrent ascites. The authors recommend that ERCP be considered in persistent acute

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Publisher

The Radiological Society of North America; Radiological Society of North America; Radiological Society of North America (RSNA) (ISSN 0033-8419)

Published

1985

Language

EN

Field

Medicine (Health Sciences)