[Liver rupture in preterm infants with a gestational age < 28 weeks].
BACKGROUND
Liver rupture is a rare complication in preterm infants and may be associated with birth trauma, cardiopulmonary resuscitation, laparotomy or coagulopathies. Only few patients are reported who have survived neonatal liver rupture. The aim of our study was to identify extremely preterm infants with liver rupture during a 6-year period.


METHODS
All preterm infants < 28 weeks gestational age admitted to the neonatal intensive care unit between 2001 and 2006 were studied retrospectively by chart review and screening of electronic files.


RESULTS
All 113 infants admitted to the neonatal intensive care unit during the study period were included. 4 infants with liver rupture were identified. In 3 cases the liver rupture was associated with cardiopulmonary resuscitation. Bleeding control was achieved only in 1 patient. All patients died, 3 because of haemorrhagic shock and 1 because of pneumopericardium.


CONCLUSIONS
Liver rupture should considered in neonates with otherwise unexplained hypovolaemia or anaemia. Neonates with a history of cardiopulmonary resuscitation should be evaluated carefully for possible liver injuries.
Haase
R
R
Abteilung für Neonatologie und Kinderintensivmedizin, Universitätsklinik und Poliklinik für Kinder- und Jugendmedizin, Martin-Luther-Universität Halle-Wittenberg. roland.haase@medizin.uni-halle.de
Hinz
L
L
Lieser
U
U
Schmidt
V
V
Milzsch
M
M
Merkel
N
N
D001720:Birth Injuries / Q000000981:diagnostic imaging* / Q000473:pathology; D002585:Cesarean Section; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D005865:Gestational Age; D006336:Heart Massage / Q000009:adverse effects*; D006452:Hemoglobinometry; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008099:Liver / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D008297:Male; D011026:Pneumopericardium / Q000000981:diagnostic imaging / Q000473:pathology; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012421:Rupture / Q000000981:diagnostic imaging / Q000473:pathology; D012771:Shock, Hemorrhagic / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography