Fatal Case of Subcapsular Liver Hemorrhage in Late Pregnancy: A Review of Hemorrhages Caused by Hepatocellular Hyperplastic Nodules

• NCJ Number: 243713
• Journal: Journal of Forensic Sciences Volume: 58 Issue: S 1 Dated: January 2013 Pages: S 253-S 257
• Author(s): Daisuke Yajima, Ph.D.; Fukuo Kondo, Ph.D.; Yukio Nakatani, Ph.D.; Hisako Saitoh, Ph.D.; Mutsumi Hayakawa, Ph.D.; Yayoi Sato, Ph.D.; Katsura Otsuka, Ph.D.; Kaoru Sato, M.T.; Hirotaro Iwase, Ph.D.
• Date Published: January 2013
• Length: 5 pages
• Publication Format: Article
• Publication Type: Case Study
• Language: English
• Country: United States of America

Annotation

This study examined the unexpected death of a pregnant woman.

Abstract

A previously healthy 23-year-old woman was admitted to hospital with abdominal pain at 39 weeks 0 days of pregnancy. The patient suffered sudden cardiopulmonary arrest during the observation and unfortunately died. An autopsy was performed to determine the cause of death. Opening of the peritoneal cavity revealed 2,220 mL of blood and a subcapsular hematoma weighing 1,060 g on the anterior surface of the right hepatic lobe. A lesion of c. 1 cm in diameter was noted at the center of the front surface of the right hepatic lobe, which was shown on histological examination to be a focal nodular hyperplasia-like lesion. The cause of death was found to be hypovolemic shock caused by bleeding of the rupture of the hepatocellular hyperplastic nodule. Although some previous case reports describe hemorrhage from such lesions, forensic pathologists should be aware that they can lead to severe bleeding and sometimes death. Abstract published by arrangement with John Wiley & Sons.