{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T11:11:27Z","timestamp":1698318687955},"reference-count":16,"publisher":"Akademiai Kiado Zrt.","issue":"8","license":[{"start":{"date-parts":[[2022,2,20]],"date-time":"2022-02-20T00:00:00Z","timestamp":1645315200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2022,2,20]]},"abstract":"<jats:p><jats:bold>\u00d6sszefoglal\u00f3.<\/jats:bold> Az \u201eakut has\u201d, mint k\u00f3rk\u00e9p, a v\u00e1rand\u00f3ss\u00e1g sor\u00e1n mind\n                    diagnosztikailag, mind ter\u00e1pi\u00e1san nagy kih\u00edv\u00e1st jelent a sz\u00fcl\u00e9sz sz\u00e1m\u00e1ra a\n                    megv\u00e1ltozott anat\u00f3miai viszonyok \u00e9s a k\u00e9palkot\u00f3 elj\u00e1r\u00e1sok korl\u00e1tozott\n                    haszn\u00e1lhat\u00f3s\u00e1ga miatt. K\u00f6zlem\u00e9ny\u00fcnkben bemutatjuk egy harmadik trimeszterbeli\n                    gravida hasi v\u00e9r\u00f6mleny\u00e9nek az eset\u00e9t, melynek v\u00e9rz\u00e9sforr\u00e1sa irodalmi ritkas\u00e1g, a\n                    v\u00e9rz\u00e9s t\u00edpus\u00e1t a felkereshet\u0151 irodalomban m\u00e9g nem \u00edrt\u00e1k le terhesekn\u00e9l. Az\n                    esettanulm\u00e1ny meg\u00edr\u00e1sa a p\u00e1ciens orvosi dokument\u00e1ci\u00f3i \u00e9s az ell\u00e1t\u00e1s\u00e1ban\n                    r\u00e9sztvev\u0151 klinikusok, patol\u00f3gusok leletei \u00e9s besz\u00e1mol\u00f3i alapj\u00e1n t\u00f6rt\u00e9nt. A\n                    v\u00e1rand\u00f3ss\u00e1g\u00e1nak 33. het\u00e9ben j\u00e1r\u00f3 gravida akut hasi t\u00fcnetegy\u00fcttessel jelentkezett\n                    klinik\u00e1nkon, anamn\u00e9zis\u00e9b\u0151l trauma kiz\u00e1rhat\u00f3 volt. Az anya roml\u00f3\n                    kardiorespiratorikus \u00e1llapota miatt s\u00fcrg\u0151ss\u00e9gi cs\u00e1sz\u00e1rmetsz\u00e9ssel \u00e9l\u0151,\n                    korasz\u00fcl\u00f6tt magzatot seg\u00edtett\u00fcnk vil\u00e1gra. A m\u0171t\u00e9t sor\u00e1n kb. 1500 ml v\u00e9rt\n                    tal\u00e1ltunk a has\u00fcregben, melynek ok\u00e1t \u00e1ltal\u00e1nos seb\u00e9sz bevon\u00e1s\u00e1val kerest\u00fck.\n                    Akt\u00edv v\u00e9rz\u00e9sforr\u00e1sk\u00e9nt a l\u00e9p ereinek ter\u00fclet\u00e9r\u0151l v\u00e9n\u00e1s jelleg\u0171 sziv\u00e1rg\u00f3 v\u00e9rz\u00e9st\n                    tal\u00e1ltunk, ez\u00e9rt splenectomia mellett d\u00f6nt\u00f6tt\u00fcnk. Az elt\u00e1vol\u00edtott szervkomplexum\n                    teljes sz\u00f6vettani feldolgoz\u00e1sa helyenk\u00e9nt a kisebb l\u00e9philusi v\u00e9na\u00e1gak\n                    izomfal\u00e1nak felrostoz\u00f3d\u00e1s\u00e1t \u00e9s fokozatos elt\u0171n\u00e9s\u00e9t igazolta, a patol\u00f3gus a\n                    v\u00e9rz\u00e9s ok\u00e1t a meggyeng\u00fclt \u00e9rfal endothelen kereszt\u00fcli v\u00e9rsziv\u00e1rg\u00e1s\u00e1nak\n                    v\u00e9lem\u00e9nyezte, definit\u00edv \u00e9rfalszakad\u00e1sra utal\u00f3 elv\u00e1ltoz\u00e1s nem volt azonos\u00edthat\u00f3.\n                    A haemoperitoneum v\u00e1rand\u00f3ss\u00e1g alatt kifejezetten ritka k\u00f3rk\u00e9p, azonban\n                    mortalit\u00e1sa mind az any\u00e1ra, mind a magzatra n\u00e9zve rendk\u00edv\u00fcl magas. Irodalmi\n                    adatok alapj\u00e1n a v\u00e9rz\u00e9sforr\u00e1s leggyakrabban a kismedencei szervek ter\u00fclet\u00e9n\n                    jelentkezik. Ritk\u00e1n a l\u00e9part\u00e9ria aneurysm\u00e1j\u00e1nak ruptur\u00e1ja is el\u0151fordul\n                    terhess\u00e9gben, a l\u00e9pv\u00e9n\u00e1s eredet\u0171 v\u00e9rz\u00e9s viszont irodalmi ritkas\u00e1gnak sz\u00e1m\u00edt, \u00e9s\n                    az \u00f6sszes feldolgozott \u00e9s k\u00f6z\u00f6lt esetben az \u00e9r szakad\u00e1sos s\u00e9r\u00fcl\u00e9se volt a f\u0151 ok,\n                    az eset\u00fcnkben le\u00edrt, ismeretlen etiol\u00f3gi\u00e1j\u00fa, \u00e9rfalveszt\u00e9ses hemorrh\u00e1gi\u00e1t sehol\n                    nem eml\u00edtik. A v\u00e1rand\u00f3sunk ell\u00e1t\u00e1s\u00e1n\u00e1l ell\u00e1t\u00e1s\u00e1n\u00e1l kulcsfontoss\u00e1g\u00fa volt a\n                    gyorsan elv\u00e9gzett explorat\u00edv laparotomia, mely a k\u00f3rk\u00e9p ok\u00e1t felder\u00edtette \u00e9s\n                    megsz\u00fcntette, lehet\u0151v\u00e9 t\u00e9ve az anya \u00e9s gyermeke t\u00fal\u00e9l\u00e9s\u00e9t \u00e9s fel\u00e9p\u00fcl\u00e9s\u00e9t.\n                    Eset\u00fcnk r\u00e1mutat arra, hogy a v\u00e1rand\u00f3ss\u00e1gi has\u0171ri v\u00e9r\u00f6mlenyek k\u00f3roktana ak\u00e1r\n                    irodalmi ritkas\u00e1gokat is rejthet, azaz a pontos ok kider\u00edt\u00e9s\u00e9vel, lumenes\n                    v\u00e9rz\u00e9sforr\u00e1s keres\u00e9s\u00e9vel nem szabad sz\u00fcks\u00e9gtelen id\u0151t veszteni az \u00e9desanya \u00e9s\n                    gyermeke \u00e9letment\u0151 ell\u00e1t\u00e1s\u00e1nak rov\u00e1s\u00e1ra. Orv Hetil. 2022; 163(8): 328\u2013332.<\/jats:p>\n                <jats:p><jats:bold>Summary.<\/jats:bold> Acute abdomen during pregnancy is a major challenge for\n                    physicians, due to the altered anatomical conditions and the limited use of\n                    medical imaging. We present a pregnant woman with a rare form of abdominal\n                    bleeding. This case study is based on the patient\u2019s medical documentations and\n                    interviews with her physicians. A woman in the 33rd week of her pregnancy was\n                    admitted to our department with acute abdomen, trauma was ruled out. Due to the\n                    deteriorating cardiorespiratory status we performed an emergency caesarean\n                    section delivering a living premature newborn. A general surgeon was present,\n                    and 1500 ml of blood was evacuated from the abdomen. Active venous type bleeding\n                    was present from the splenic vessels, therefore we performed a splenectomy. The\n                    histopathological analysis of the whole organ complex showed that the media\n                    layer segmentally and progressively disappeared in the splenic hilar veins,\n                    giving rise to the high probability that the bleeding was caused by a\n                    diathesis-type leakage through the endothelium and to the weakened media layer\n                    in the absence of a luminal-type vessel rupture. Hemoperitoneum during pregnancy\n                    is an exceptionally rare condition, however its mortality rate is high both for\n                    the mother and the fetus. The bleeding usually originates from the pelvis. On\n                    rare occasions the bleeding occurs from the splenic vessels although most of\n                    them are arterial bleedings from an aneurysm.In our case the emergency\n                    laparotomy was essential for the correct diagnosis and the treatment, which\n                    resulted in saving and recovering both the mother and the fetus. Orv Hetil.\n                    2022; 163(8): 328\u2013332.<\/jats:p>","DOI":"10.1556\/650.2022.32345","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T21:00:51Z","timestamp":1668805251000},"page":"328-332","update-policy":"http:\/\/dx.doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":0,"title":["Ritka has\u0171ri v\u00e9rz\u00e9s a vena lienalis \u00e1grendszer\u00e9b\u0151l v\u00e1rand\u00f3ss\u00e1g alatt"],"prefix":"10.1556","volume":"163","author":[{"given":"Bal\u00e1zs","family":"Hamar","sequence":"first","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Sz\u00fcl\u00e9szeti \u00e9s N\u0151gy\u00f3gy\u00e1szati Klinika Budapest Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bal\u00e1zs","family":"B\u00f6rzs\u00f6nyi","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Sz\u00fcl\u00e9szeti \u00e9s N\u0151gy\u00f3gy\u00e1szati Klinika Budapest Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N\u00e1ndor","family":"\u00c1cs","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Sz\u00fcl\u00e9szeti \u00e9s N\u0151gy\u00f3gy\u00e1szati Klinika Budapest Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tibor","family":"Glasz","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, II. 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