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Cirrhosis is a progressive chronic liver injury caused by prolonged inflammation, excessive fibrotic remodeling, and impaired regeneration. Over time, repeated hepatic insults disrupt the liver’s architecture and function, leading to reduced blood flow, impaired bile drainage, and diminished metabolic capacity.Pathophysiology of cirrhosisCirrhosis arises from three main responses to chronic liver damage: inflammation, immune activation, and hepatocyte death. These processes lead to...
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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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[HELLP syndrome complicated by liver rupture - case report].

M Součková, R Pilka, T Malý

    Ceska Gynekologie
    |July 24, 2014
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    A rare but serious complication of HELLP syndrome is liver rupture during pregnancy. Prompt surgical intervention, including liver repair and tamponade, is crucial for maternal and fetal survival.

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    Area of Science:

    • Obstetrics and Gynecology
    • Maternal-Fetal Medicine
    • Surgical Management of Pregnancy Complications

    Background:

    • HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) is a severe condition complicating pregnancy.
    • Liver rupture is a life-threatening complication of HELLP syndrome, occurring in approximately 3.8% of cases.

    Observation:

    • A 31-year-old pregnant patient presented at 36 weeks gestation with severe epigastric pain, hypotension, and edema.
    • Physical examination revealed signs of shock, necessitating urgent intervention.
    • Intraoperative findings during cesarean section confirmed a ruptured liver.

    Findings:

    • The patient underwent cesarean section, during which liver rupture was identified.
    • Successful management involved a multidisciplinary team, employing liver suture, hemostatic materials, and Mikulicz tamponade.
    • Both mother and neonate survived due to timely and coordinated care.

    Implications:

    • Liver rupture in HELLP syndrome requires immediate surgical management, potentially involving liver suture, hemostatic techniques, or resection.
    • Effective interdisciplinary teamwork is vital for managing such critical obstetric emergencies.
    • This case underscores the importance of recognizing and rapidly treating HELLP syndrome to prevent catastrophic outcomes like liver rupture.