Hematoma After Transversus Abdominis Plane Block in a Patient With HELLP Syndrome: A Case Report.

Shirozu K, Kuramoto S, Kido S et al.

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.

A & A case reports. Mar 2017.

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.

Pubmed

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