Modified rapid deployment hemostat terminates bleeding from hepatic rupture in third trimester.

Severe atraumatic intraperitoneal hemorrhage is uncommon during the third trimester of pregnancy. Within this small population of patients, ruptured hepatic adenoma, ruptured splenic artery aneurysm, and uterine rupture represent three common causes of antepartum third trimester intraperitoneal bleeding. Other less common causes include spontaneous bleeding because of the HELLP Syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) and intraperitoneal rupture of a placentia previa with percreta, among others. This case report describes the use of the Modified Rapid Deployment Hemostat (MRDH, Marine Polymer Technologies, Inc., Danvers, Mass.) to control exsanguniating hemorrhage in a patient with severe pre-eclampsia that was found to have a large spontaneous liver injury. With the scope of trauma surgery evolving into a more generalized trauma and emergency general surgery specialty, this report is also intended to provide insight into an uncommon but life-threatening cause of hemorrhage that may confront the emergency general surgeon.