Gross hemorrhage under the capsule of the liver or from rupture of the parenchyma appears to be a direct cause or a significant factor in 1.2 to 5.6% of stillbirths and neonatal deaths, according to the author from this review of the literature. This form of intra-abdominal hemorrhage has not been readily recognized during life judging from the nature of the reports, nearly all of which are based on necropsy. The clinical manifestations are distinctive. The infants generally appear normal for the first 48 hours of life and then develop pallor and a decreasing concentration of hemoglobin in the blood, rapidly progressing to sudden collapse. A swelling may be palpated in the vicinity of the liver. Bleeding may be severe, and prompt recognition and treatment are imperative. Transfusion is obviously the most important therapeutic measure. The amount of blood required should not be underestimated. The occasional indications for surgical laparotomy are discussed but conservative treatment is generally preferable.
Amyloidosis and Spontaneous Liver Bleeding: A Case Report and Literature Review
