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Revista Colombiana de Cirugía
Print version ISSN 2011-7582On-line version ISSN 2619-6107
Abstract
PACHECO-MOLINA, Carlos; VERGARA-MIRANDA, Héctor; ALVAREZ-LOZADA, Luis Adrián and VASQUEZ-FERNANDEZ, Francisco. Management of spontaneous hepatic rupture in HELLP syndrome. rev. colomb. cir. [online]. 2021, vol.36, n.3, pp.549-553. Epub July 20, 2021. ISSN 2011-7582. https://doi.org/10.30944/20117582.664.
Introduction.
HELLP syndrome is a severe variant of preeclampsia with a low incidence, between 0.5-0.9% of all pregnancies. Spontaneous hepatic rupture in pregnancy is rare, has a high mortality, and has been associated with hepatic hemangiomas, choriocarcinoma, and HELLP syndrome.
Clinical case.
29-year-old woman with a 34.3-week pregnancy, with progressive uterine activity and acute fetal distress and findings compatible with HELLP syndrome. An emergency cesarean section was performed, finding hemoperitoneum and hepatic rupture of the right lobe, performing abdominal packing and subsequent surgical reoperation.
Discussion.
Spontaneous liver rupture in pregnancy is a rare and potentially fatal entity. A high level of suspicion is essential to make the diagnosis and prompt intervention. It requires multidisciplinary management for a successful outcome. Multiple treatments have been described that depend on the clinical manifestations and extent of the lesion, but it is clear that primary laparotomy and packing constitute the best choice before the intraoperative finding.
Keywords : HELLP syndrome; rupture, spontaneous; liver pregnancy complications; surgery reoperation; damage control.