title: Hematoma After Transversus Abdominis Plane Block in a Patient With HELLP Syndrome: A Case Report.
abstract: We herein present a case of intramuscular hematoma that developed after transversus abdominis plane block in a patient undergoing cesarean delivery. The patient had HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) preoperatively. Ultrasonography-guided transversus abdominis plane block was performed at the end of surgery. Postoperatively, the platelet count and antithrombin III level decreased, and computed tomography revealed intramuscular hematomas that possibly were related to vascular injury and potential disseminated intravascular coagulation. We should be mindful of the possibility of intramuscular hematoma formation in patients with HELLP syndrome, even when using ultrasound guidance.
authors.affiliation: From the *Operating Rooms, Kyushu University Hospital, Fukuoka, Japan; †Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital, Fukuoka, Japan; ‡Department of Obstetrics and Gynecology, Kyushu University Hospital, Fukuoka, Japan; and §Department of Anesthesiology and Critical Care Medicine, Kyushu University Graduate School of Medicine, Fukuoka, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Shirozu
authors.forename: Sumiko
authors.initials: S
authors.lastname: Kuramoto
authors.forename: Saki
authors.initials: S
authors.lastname: Kido
authors.forename: Kengo
authors.initials: K
authors.lastname: Hayamizu
authors.forename: Yuji
authors.initials: Y
authors.lastname: Karashima
authors.forename: Sumio
authors.initials: S
authors.lastname: Hoka
mesh_terms: D000009:Abdominal Muscles / Q000000981:diagnostic imaging / Q000294:innervation*; D000328:Adult; D016362:Analgesia, Obstetrical / Q000009:adverse effects* / Q000379:methods; D002585:Cesarean Section / Q000009:adverse effects*; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D004630:Emergencies; D005260:Female; D017359:HELLP Syndrome / Q000175:diagnosis / Q000601:surgery*; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D009407:Nerve Block / Q000009:adverse effects* / Q000379:methods; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D010976:Platelet Count; D011247:Pregnancy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D057772:Vascular System Injuries / Q000209:etiology