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Case reports have documented numerous pseudoaneurysms in the area of hemorrhage, raising the possibility of a vasculopathy contributing to this rare disorder.35 Patients with hepatic rupture typically present in shock, with preceding right upper quadrant pain, hypertension, elevated transaminase levels (greater than 1,000 hot fat girls IU per L) and coagulopathy.4 Therapy for hepatic rupture has included transfusion of blood products and intravenous fluids, surgical evacuation and arterial embolization.4 These therapies have met with only moderate success; a 59 to 70 percent maternal hot fat girls mortality rate and a 75 percent hot fat girls perinatal mortality rate have been noted in hepatic rupture.4 Late complications arising after treatment of hepatic rupture include hepatic abscess formation and pleural effusions. Hepatic infarction is best detected by using computed tomographic scans or magnetic resonance imaging.2,36
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