[A case of hepatic and splenic peliosis occurring in the puerperium after normal pregnancy].
The authors report a case of Peliosis of the liver and of the spleen that occurred at term after a normal pregnancy that lasted 38 weeks. The delivery was complicated by amniotic infection with hemorrhagic shock and uterine inertia that gave rise to the need for a sub-total hysterectomy in order to stop the bleeding. The progress of the case was made worse by the development of the disseminated intra-vascular coagulation syndrome with septicaemia and pulmonary oedema. When the operation was carried out to stop the bleeding it was noted that the liver was enlarged, hard, smooth and dark in colour and the histological specimen showed a major degree of Peliosis hepatis. The same lesions were found in the region of the spleen and a lymph node. The patient died 14 days after delivery of acute renal failure together with cerebral oedema and septic shock. The authors consider that the aetiology of the Peliosis could be due to hormone changes of pregnancy associated with septicaemia. The anatomical evolution of Peliosis hepatis to widespread necrosis of the parenchyma makes it possible to understand that the condition of diffuse intra-vascular coagulation will not improve in the presence of hepato-cellular insufficiency.
D000328:Adult; D004211:Disseminated Intravascular Coagulation / Q000150:complications; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000209:etiology / Q000473:pathology; D008297:Male; D010382:Peliosis Hepatis / Q000209:etiology / Q000473:pathology; D011247:Pregnancy; D011644:Puerperal Disorders / Q000473:pathology; D012771:Shock, Hemorrhagic / Q000150:complications; D013154:Spleen / Q000473:pathology; D013158:Splenic Diseases / Q000209:etiology / Q000473:pathology; D014593:Uterine Inertia / Q000150:complications
Une observation de péliose hépatique et splénique survenue dans le post-partum au terme d'une grossesse normale.