Spontaneously Ruptured Subcapsular Liver Hematoma Associated With Hemolysis, Elevated Liver Enzymes and Low Platelets (HELLP) Syndrome

摘要

Spontaneous subcapsular liver hemorrhage with or without rupture is an uncommon but potentially lethal complication of pregnancy [1]. It is often associated withsevere preeclampsia or the HELLP (hemolysis, elevatedliver enzymes, and low platelet count) syndrome [1]. Thematernal mortality rate is very high when hepatic ruptureoccurs, varying from 18% to 86% [2]. Early evaluationwith imaging, appropriate diagnosis and prompt management are very important. Improved survival can beachieved through prompt recognition and a multidisciplinary approach [1]. To date, most cases have beenmanaged with an aggressive operative approach, butsurgery might not always be necessary if the patient isclosely monitored [3]. We present a case of spontaneousrupture of subcapsular liver hematoma in associationwith HELLP syndrome, and the patient was successfullytreated after surgical packing at laparotomy.