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Revista Colombiana de Cirugía
versão impressa ISSN 2011-7582versão On-line ISSN 2619-6107
Resumo
PACHECO-MOLINA, Carlos; VERGARA-MIRANDA, Héctor; ALVAREZ-LOZADA, Luis Adrián e VASQUEZ-FERNANDEZ, Francisco. Management of spontaneous hepatic rupture in HELLP syndrome. rev. colomb. cir. [online]. 2021, vol.36, n.3, pp.549-553. Epub 20-Jul-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.
Palavras-chave : HELLP syndrome; rupture, spontaneous; liver pregnancy complications; surgery reoperation; damage control.