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Liver Subcapsular Hematoma Conservative Treatment in HELLP (Hemolysis, Elevated Liver Enzymes, and Low Platelet
Elizabeth Aide Gómez Vega1, Edgar Mendoza Reyes1, Abril A Arellano Llamas2
1Obstetrics and Gynecology, Unidad Médica de Alta Especialidad, Hospital de Ginecología y Obstetricia No.3 "Dr Víctor Manual Espinosa De los Reyes Sánchez" Centro Médico Nacional La Raza, México, MEX.
Subcapsular hepatic hematoma is a life-threatening complication during pregnancy. Conservative treatment could be possible with an equipped unit and a fully staffed team available 24 hours a day. We present the case of a 40-year-old patient at 37 weeks of gestation with preeclampsia meeting severe features who presented with diffuse abdominal pain radiating to the right shoulder. In a private hospital, during a cesarean section, hepatic bleeding was observed. In our hospital, partial HELLP (Hemolysis, Elevated liver enzymes, and Low Platelet count) syndrome was diagnosed, and treatment began. Once stabilized, a CT scan revealed two subcapsular hepatic hematomas with a total volume of 1700 cc. The multidisciplinary team adopted a conservative management approach, incorporating close clinical and biochemical follow-up. After 25 days, the patient was discharged home with a significant reduction in the size of both hematomas.
Subcapsular hepatic hematoma is a life-threatening complication during pregnancy. Conservative treatment could be possible with an equipped unit and a fully staffed team available 24 hours a day. We present the case of a 40-year-old patient at 37 weeks of gestation with preeclampsia meeting severe features who presented with diffuse abdominal pain radiating to the right shoulder. In a private hospital, during a cesarean section, hepatic bleeding was observed. In our hospital, partial HELLP (Hemolysis, Elevated liver enzymes, and Low Platelet count) syndrome was diagnosed, and treatment began. Once stabilized, a CT scan revealed two subcapsular hepatic hematomas with a total volume of 1700 cc. The multidisciplinary team adopted a conservative management approach, incorporating close clinical and biochemical follow-up. After 25 days, the patient was discharged home with a significant reduction in the size of both hematomas.
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