EDITOR'S QUIZ: GI SNAPSHOT.... Liver failure after delivery

May 2005
Gut;May2005, Vol. 54 Issue 5, p672
Academic Journal
The article frames a question after discussing a case of liver failure after delivery. A 32 year old, gravida 2, para 2, was admitted at 36 weeks' gestation with upper abdominal pain. During her second pregnancy she frequently had epistaxis. At 39 weeks' gestation she delivered a healthy girl after an elective caesarean section which was complicated by a total blood loss of 1.5 liters. Continuing abdominal bleeding was suspected and at laparotomy 5 liters of blood were found in the abdominal cavity from sites of recently lysed adhesions. On day 4 post partum, liver failure worsened with grade IV encephalopathy necessary to perform an orthotopic liver transplantation. The procedure was complicated by severe intraoperative bleeding (30 liters).


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