Anaesthetic management of liver haemorrhage during laparotomy in a premature infant with necrotizing enterocolitis

The case of a 680 g premature baby who developed massive spontaneous liver haemorrhage during laparotomy for necrotizing enterocolitis is reported. Th e infant survived due to rapid and massive fluid administration, including transfusion of large volumes of blood and blood products, in combination wi th high dose inotropic support and the surgical use of packing with thrombo static sponges. Good venous access, including two central venous lines, tur ned out to be very useful.