Abstract
A 23-yr-old woman presented in labour and hepatic failure. The clinical diagnosis was acute fatty liver of pregnancy. A Caesarean section was performed under epidural anaesthesia, after correction of a coagulopathy. Epidural anaesthesia was chosen because of the potential deleterious effects of general anaesthesia on liver blood flow and function.
Résumé
Une femme de 23 ans en défaillance hépatique s’est présentée pour accouchement. Le diagnostic clinique était une stéatose hépatique aiguë de la grossesse. Une césarienne fut faite sous anesthésie épidurale après correction de sa coagulopathie. L’anesthésie épidurale fut choisie à cause des effets néfastes potentiels de l’anesthésie générale sur le flot sanguin hépatique et la fonction hépatique.
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References
McCammon RL. Diseases of the liver and biliary tract.In: Stoelting RK, Dierdorf SF (Eds.). Anesthesia and Co-existing Disease. New York: Churchill Livingstone 1983; 347–8.
Sherlock S. Diseases of the Liver and Biliary System. Oxford: Blackwell Scientific Publications, 1985; 420–8.
Krejs GJ, Haemmerli UP. Miscellaneous disorders.In: Schiff L, Schiff ER (Eds.). Diseases of the Liver. Philadelphia: JB Lippincott, 1982; 1561–80.
Samuels P, Landon MB. Medical complications.In: Gabbe SG, Niebyl JR, Simpson JL (Eds.). Obstetrics: Normal and Problem Pregnancies. New York: Churchill-Livingstone, 1986; 938–9.
Reily CA, Latham PS, Romero R, Duffy TP. Acute fatty liver of pregnancy. Ann Int Med 1987; 106; 703–6.
Burroughs AK, Seong NH, Dojcinov DM, Scheuer PJ, Sherlock SVP. Idiopathic acute fatty liver of pregnancy in 12 patients. Q J Med 1982; 51: 481–97.
Powell-Jackson P, Greenway B, Williams R. Adverse effects of exploratory laparotomy in patients with unsuspected liver disease. Br J Surg 1982; 69: 449–51.
Aranha GV, Greenlee HB. Intra-abdominal surgery in patients with advanced cirrhosis. Arch Surg 1986; 121: 275–7.
Gelman SI. Disturbances in hepatic blood flow during anesthesia and surgery. Arch Surg 1976; 111: 881–3.
Cooperman LH, Warden JC, Price HL. Splanchnic circulation during nitrous oxide anesthesia and hypocarbia in normal man. Anesthesiology 1968; 29: 254–8.
Gelman S. General anesthesia and hepatic circulation. Can J Physiol Pharmacol 1987; 65: 1762–79.
Runciman WB, Mather LE, Ilsley AH, Carapetis RJ, Upton RN. A sheep preparation for studying interactions between blood flow and drug disposition. III: Effects of general and spinal anaesthesia on regional blood flow and oxygen tensions. Br J Anaesth 1984; 56: 1247–58.
Kehlet H. Modification of responses to surgery by neural blockade: clinical implications.In: Cousins MJ, Bridenbaugh PO (Eds.). Neural Blockade in Clinical Anesthesia and Management of Pain, Philadelphia: JB Lippincott, 1988; 145–88.
Goldfarb G, Debaene B, Ang ET, Roulot D, Jolis P, Lebrec D. Hepatic blood flow in humans during isoflurane N2O and halothane-N2O anesthesia. Anesth Analg 1990; 71: 349–53.
Conzen PF, Hobbhahn J, Goetz AE et al. Splanchnic oxygen consumption and hepatic surface oxygen tensions during isoflurane anesthesia. Anesthesiology 1988; 69: 643–51.
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Antognini, J.F., Andrews, S. Anaesthesia for caesarean section in a patient with acute fatty liver of pregnancy. Can J Anaesth 38, 904–907 (1991). https://doi.org/10.1007/BF03036971
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DOI: https://doi.org/10.1007/BF03036971