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Abstract

OBJECTIVE: TO REPORT A CASE OF OBSTRUCTIVE SHOCK SECONDARY TO HEPATIC HAEMATOMA

*Dr. Cyril Jacob Chacko, MD, FRCA, FFICM

ABSTRACT

We would like to present a case report of a 34 year old female developed spontaneous hepatic haematoma causing acute compression of the inferior vena cava (IVC) resulting in life threatening hemodynamic instability. initiation of invasive cardiac output monitoring LIDCO, Use of vasopressors, transfer to tertiary liver transplant centre The evolution of the hepatic haematoma lead to the obstruction of the thoracic IVC, which lead to decrease in preload. Even with adequate fluid resuscitation she continued to have significant cardiovascular instability. The patient was supported with vasopressors to maintain an adequate cardiac output. With time the size of the haematoma receded leading to improvement in haemodynamic, acid –base parameters and liver function. Various treatment modalities were considered for this case. Close monitoring, haemodynamic support and continuous renal replacement therapy was sufficient until the obstruction resolved.

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