SUBCAPSULAR HAEMATOMA OF THE LIVER IN A CASE ODISSEMINATED INTRAVASCULAR COAGULATION SECONDARY TO A BLEEDING PLACENTA PREVIA

Abstract

The following case report is on a 43 year old lady who had presented with profuse antepartum haemorrhage due to a placenta praevia Type 4 anterior. Following hysterectomy she developed DIVC that was corrected with platelets and FFP. Subsquently on 7th. Post-op day she had complains of abdominal distension and right hypochondrium fullness. An ultrasound and CT scan was done which showed a large subcapsular haematoma of the liver. This was then aspirated.
Formation of a subcapsular haematoma following DIVC is a rare event. No case of subcapsular haematoma has been reported following DIVC from a bleeding placenta praevia. This case illustrates the pathophysiology of DIVC as well as the imaging modalities in the diagnosis of a subcapsular haematoma.
Spontaneous subcapsular haematoma of the liver is a rare event. In most of the reported cases it was most often associated with toxaemias of pregnancy (2,4,5,6). No cases of spontaneous subcapsular haematomas have been reported following haemorrhage due to placenta praevia. The following report is of a case of Type 4 anterior placenta praevia who suffered excessive blood loss from ante and postpartum haemorrhage which eventually led to disseminated intravascular coagulation.