• Fatal abdominal hemorrhage was found, in the two cases reported, to have resulted from intrahepatic vascular disease and rupture of the liver. Extreme ischemic infarction due to intrahepatic arterial thrombosis led to hemorrhage into the liver and spontaneous tearing of its capsule.
Retrospective study did not reveal anything characteristic in the symptoms preceding the rupture, and when this did occur the signs and symptoms resembled those of any acute abdominal accident. There is hardly any rational treatment known that might have prevented the hemorrhage in these two cases. Once hemorrhage has occurred, laparotomy is essential, but shock is profound and conditions are unfavorable for surgery.
In one of these cases, in spite of the shock and hemorrhage, hemostasis was achieved and the patient made a good recovery from the operation only to die from uremia. In both cases, the underlying condition was hypertensive cardiovascular disease.
Katzenstein R, Ryan AJ. RUPTURE OF LIVER WITH FATAL HEMORRHAGE DUE TO INTRAHEPATIC VASCULAR DISEASEREPORT OF TWO CASES. JAMA. 1956;161(3):199–204. doi:10.1001/jama.1956.02970030017005
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