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CC BY 4.0 · Libyan International Medical University Journal 2023; 08(02): 060-062
DOI: 10.1055/s-0043-1776339
Case Report

Ruptured Subcapsular Liver Hematoma: A Rare Complication of HELLP Syndrome

Autoren

  • Abtisam Alharam 

    1   Department of General Surgery, Benghazi Medical Center, Benghazi, Libya

  • Tawfik Abuzalout

    2   Department of Surgery, Benghazi University, Benghazi, Libya

  • Haitham Elmehdawi 

    3   Department of Surgery, Libyan International Medical University, Benghazi, Libya
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Abstract

This case report highlights the rare and life-threatening complication of ruptured subscapular liver hematoma in the setting of hemolysis, elevated liver enzymes, and low platelets syndrome, a complication associated with pre-eclampsia. A 30-year-old pregnant woman at 38 weeks of gestation presented with high blood pressure, exaggerated neurological reflexes, and high levels of albumin in her urine. Her condition deteriorated over time, and liver function tests revealed elevated readings. An emergency cesarean section was performed, during which a large liver tear with active bleeding and rupture of the liver capsule in the right lobe were discovered. An exploratory laparotomy revealed a massive hemoperitoneum with active bleeding, and hepatic packing was performed using three gauzes. Despite this, the patient's liver parameters continued to worsen, and she was transferred to the intensive care unit for further resuscitation. After 72 hours, she underwent a second operation to remove the gauze packing, and hemostasis was successfully achieved without any active bleeding. Early detection of ruptured subcapsular liver hematoma and a coordinated approach involving medical, obstetrical, radiology, and surgical teams can lead to successful treatment of this rare and dangerous complication.

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Keywords

subcapsular liver hematoma - HELLP syndrome - liver injury - pregnancy


Publikationsverlauf

Artikel online veröffentlicht:
13. Dezember 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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