Year 2023 / Volume 115 / Number 8
Letter
Ruptured subcapsular liver hematoma as a rare complication of HELLP syndrome. A therapeutic challenge

465-466

DOI: 10.17235/reed.2022.9276/2022

Luis Alejandro García González, Raquel Rodríguez Uría, Pablo Noriega Menendez, Lorena Solar Garcia, Alberto Miyar de León, Ignacio María González-Pinto Arrillaga, José Electo Granero Trancón,

Abstract
HELLP syndrome (HS), a low-incidence condition of uncertain pathogenesis associated with pregnancy hypertensive syndromes, is characterized by hemolysis, elevated liver enzymes and low platelet count. Ruptured subcapsular liver hematoma complicated with hemoperitoneum is an uncommon but very serious condition where early recognition and multidisciplinary management are key to reduce its associated maternal, infant mortality rate. Symptoms are nonspecific, characterized by por epigastric pain, nausea and vomiting; clinical suspicion and appropriate imaging studies are of crucial importance. We report the case of a 36-year-old primiparous woman at 39 weeks of gestation. She was admitted for early membrane rupture, with delivery complicated by retained placenta. During the immediate puerperium she had blood pressure > 140/90 mmHg, epigastric pain and vomiting, which required respiratory and hemodynamic support. An exploratory laparotomy was performed that revealed a massive hemoperitoneum as well as CR in the RLL with multifocal active bleeding. The left liver lobe was macroscopically normal. The patient underwent hemoperitoneum drainage and hepatic packing (HP); biopsy findings were consistent with necrosis. Polytransfusion was initiated with blood products and antihemorrhagic agents.
Share Button
New comment
Comments
No comments for this article
References
1. Mazzola A, Magro B, Perdigao F, Charlotte F, Atif M, Goumard C, et al. Acute liver failure and HELLP syndrome: A clinical case and literature review. Clinics and Research in Hepatology and Gastroenterology. 2021;45(2).
2. Rath W, Tsikouras P, Stelzl P. HELLP Syndrome or Acute Fatty Liver of Pregnancy: A Differential Diagnostic Challenge. Geburtshilfe Frauenheilkd. 2020;80(5):499–507.
3. Marsh FA, Kaufmann SJ, Bhabra K. Surviving hepatic rupture in pregnancy - A literature review with an illustrative case report. Journal of Obstetrics and Gynaecology. 2003;23(2):109–13.
4. Wilson SG, White AD, Young AL, Davies MH, Pollard SG. The management of the surgical complications of HELLP syndrome. Ann R Coll Surg Engl. 2014;96(7):512–6.
Related articles

Digestive Diseases Image

Spontaneous duodenal wall hematoma

DOI: 10.17235/reed.2023.9793/2023

Letter

Hematoma post-endoscopic retrograde cholangiopancreatography

DOI: 10.17235/reed.2023.9670/2023

Letter

Amyloidosis: a rare cause of severe acute liver failure

DOI: 10.17235/reed.2023.9598/2023

Letter

Hemorrhagic complications following paracentesis

DOI: 10.17235/reed.2020.6914/2020

Letter to the Editor

A post-endoscopic retrograde cholangiopancreatography subcapsular hepatic hematoma

DOI: 10.17235/reed.2017.5123/2017

Digestive Diseases Image

Hemosuccus pancreaticus secondary to pseudoaneurysm of the splenic artery

DOI: 10.17235/reed.2017.4893/2017

Letter to the Editor

Duodenal hematoma caused by endoscopic hemostatic procedures (sclerotherapy)

DOI: 10.17235/reed.2017.4883/2017

Letter to the Editor

Intramural gastric hematoma in the context of an acute pancreatitis

DOI: 10.17235/reed.2017.4494/2016

Case Report

Hepatic hematoma after ERCP: two new case reports

DOI: 10.17235/reed.2017.4237/2016

Letter to the Editor

Hepatic subcapsular hematoma: a rare late complication after ERCP

DOI: 10.17235/reed.2016.4111/2015

Letter to the Editor

Severe acute liver failure and thyrotoxicosis: an unusual association

DOI: 10.17235/reed.2015.3607/2014

Citation tools
García González L, Rodríguez Uría R, Noriega Menendez P, Solar Garcia L, Miyar de León A, González-Pinto Arrillaga I, et all. Ruptured subcapsular liver hematoma as a rare complication of HELLP syndrome. A therapeutic challenge. 9276/2022


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 401 visits.
This article has been downloaded 65 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 11/10/2022

Accepted: 19/10/2022

Online First: 25/11/2022

Published: 26/07/2023

Article Online First time: 45 days

Article editing time: 288 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology