%0 Journal Article
%T Ruptura Hep芍tica y Espl谷nica asociada con Preeclampsia severa: Presentaci車n de un caso Hepatic and splenic rupture associated with severe Preeclampsia: a case report
%A Gerardo Gonz芍lez-Martinez
%A Jorge Aguirre-Suarez
%A Andr谷s Alarc車n-Sandoval
%A 芍ngel Pulgar-Lehr
%J Investigaci車n Cl赤nica
%D 2004
%I Scientific Electronic Library Online
%X Resumen La ruptura espl谷nica es una rara complicaci車n del embarazo y del postparto, por el contrario, la hemorragia hep芍tica es m芍s com迆n como complicaci車n del embarazo y est芍 usualmente asociada con la preeclampsia. En este trabajo reportamos el caso de una paciente de 37 a os de edad con un embarazo simple de 31,5 semanas, no controlado, con preeclampsia severa. Al momento de su ingreso a la instituci車n hospitalaria presentaba dolor abdominal, cefalea, hipertensi車n y palidez cut芍neo-mucosa acentuada. Durante su valoraci車n f赤sica de ingreso, la paciente present車 colapso circulatorio severo y se decidi車 su intervenci車n quir迆rgica. Se le practic車 una ces芍rea segmentaria y durante la exploraci車n abdominal se observ車 hemoperitoneo, ruptura espl谷nica grado III y un hematoma en cara anterolateral de h赤gado. Se realiz車 esplenectom赤a y evacuaci車n del hematoma hep芍tico. Deben considerarse la ruptura espl谷nica y el hematoma subcapsular hep芍tico como diagn車sticos diferenciales ante una inestabilidad hemodin芍mica pre, intra o postparto, bien sea natural o quir迆rgico, en pacientes con preeclampsia severa. Este trabajo constituye el primer reporte en la literatura venezolana de la asociaci車n entre ruptura espl谷nica, hematoma subcapsular hep芍tico y preeclampsia severa. Un adecuado control prenatal, el conocimiento de esta asociaci車n y una r芍pida intervenci車n terap谷utica son esenciales para asegurar la sobrevida materno-fetal. Abstract The splenic rupture is a rare complication of pregnancy and of the postpartum period. On the contrary, hepatic hemorrhage is a relatively common complication of pregnancy and it is usually associated with preeclampsia. In this work we report the case of a 37 year-old patient with a noncontrolled 35 week-pregnancy of simple, with severe preeclampsia. She presented abdominal pain, headache, hypertension and accented cutaneous-mucous paleness at the moment of admission to the hospital. During physical evaluation at admittance, the patient suddenly suffered a severe circulatory collapse and it was decided a surgical intervention. A segmental caesarean section was practiced, and during the abdominal exploration it was observed hemoperitoneous, a splenic rupture degree III and a hematoma in the anterolateral liver＊s wall. Total splenectomy and evacuation of the hepatic hematoma was performed. The splenic rupture and the hepatic subcapsular hematoma should be considered as a part of the differential diagnoses when a hemodynamic collapse occurs during labor in patients with severe preeclampsia. This work constitutes the first report in the Vene
%K Preeclampsia
%K ruptura espl谷nica
%K ruptura hep芍tica
%K complicaciones del embarazo
%K Splenic rupture
%K Preeclampsia
%K Hepatic rupture
%K pregnancy complications
%U http://wwww.scielo.org.ve/scielo.php?script=sci_arttext&pid=S0535-51332004000100007