Abdominal Distention and Paleness of a neonate after vaginal delivery: a case report

Back ground:Abdominal distention and paleness and poor feeding after normal vaginal delivery in neonate can be due to solid abdominal injury (liver, spleen, and kidney) or abdominal mass with intra mass hemorrhage in neonate.Case presentation:This case is a 4 days old male neonate who presented with abdominal distention and paleness. In physical exam: PR=160/min, BP=55/33 mmhg, RR=55/min, T=37°c. and in lab test Hb=4mg/dl. He was born with vaginal delivery. His ultrasonography showed free fluid and heterogenic mass (56×39 mm) between liver and right kidney. After resuscitation and laparotomy, we observed massive hemorrhagedue to liver injury that we repaired the liver as much as possible and then packed it with laparatomy pad and removed it 48hr later.Conclusion:Abdominal distention and paleness after difficult labor is very important. In this situation solid organ injury (liver, spleen, and kidney) must be considered and we decision making for operative or non-operative management depends on patient condition.