technetium-tc-99m-sulfur-colloid and Pre-Eclampsia

Three cases of postpartum hepatic hemorrhage in the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELP) were diagnosed by Tc-99m sulfur colloid liver-spleen scanning. Two patients had follow-up scans. One showed rapid resolution of the hematoma on the repeat scan performed six days later, while the other showed delayed resolution on the repeat scan four weeks later. All patients received non-surgical supportive therapy with or without blood transfusion after delivery, and recovered well. Usefulness of radionuclide liver-spleen scanning in the diagnosis of peripartum hepatic hemorrhage and monitoring course of the disease is emphasized.

Topics: Adult; Female; Hemolysis; Hemorrhage; Humans; Liver; Liver Diseases; Pre-Eclampsia; Pregnancy; Puerperal Disorders; Radionuclide Imaging; Syndrome; Technetium Tc 99m Sulfur Colloid; Thrombocytopenia

The diagnosis of hepatic rupture in patients with pregnancy-induced hypertension (preeclampsia and eclampsia) is rarely made preoperatively. Diagnostic imaging can be utilized in some patients to confirm the preoperative diagnosis. Since hematoma formation precedes hepatic rupture, then, when diagnostic modalities such as sonography and computed tomography identify patients with hematomas, these patients are at risk of rupture, and should be hospitalized until the hematomas resolve.

Topics: Abdomen; Adolescent; Adult; Female; Hematoma; Humans; Liver Diseases; Pain; Pre-Eclampsia; Pregnancy; Rupture, Spontaneous; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed; Ultrasonography