Spontaneous idiopathic liver hemorrhage: a systematic review of a rare entity.
Eur J Trauma Emerg Surg
; 2024 Mar 19.
Article
em En
| MEDLINE
| ID: mdl-38502311
ABSTRACT
BACKGROUND:
Spontaneous idiopathic liver hemorrhage (SILH) is a rare life-threatening condition occurring without a clear and specific etiology. A systematic review was performed to provide guidelines for the perioperative management of patients affected by SILH. A case report was also included.METHODS:
A systematic search of the last 24-year literature was conducted and the manuscript was structured following point-by-point the PRISMA guidelines.RESULTS:
After an initial selection of 6995 titles, 15 articles were considered for the final qualitative analysis (n = 22 patients, including the present report). Conservative treatment was chosen in 12 cases (54.5%) with stable clinical conditions, while 9 patients (40.9%) required a primary operative approach for emergency presentation at diagnosis. Direct liver resection was the preferred surgical treatment (n = 6), mostly major hepatectomies (n = 4). Hepatic arterial embolization was performed as the primary operative approach in three patients, followed by emergency laparotomy during the same hospitalization because of rebleeding in one case. Contrast-enhanced CT scan was the gold standard for diagnosis (n = 19).CONCLUSIONS:
Conservative treatment of SILH is mainly based on stable clinical conditions and may be considered even in case of a limited arterial blush found on imaging. The absence of underlying hepatic or systemic disorders seems to correlate with favorable outcomes and no mortality.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Idioma:
En
Revista:
Eur J Trauma Emerg Surg
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
França