Laparoscopic surgery for subcapsular hematoma of the liver with preeclampsia: a case report

Subcapsular liver hematoma (SLH) is a rare but potentially life-threatening complication of pregnancy. And SLH is a severe manifestation of hypertensive disorders in pregnancy. Early prevention, prompt identification, and multidisciplinary management are crucial. We present a case of SLH successfully treated by laparoscopic surgery.

This paper described the case of a 37-year-old Chinese woman (gravida 6, para 0) who was diagnosed with preeclampsia and hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome upon admission. After admission, the patient was found to have elevated blood pressure and positive urine protein. She developed right upper abdominal pain before delivery, and abnormal liver function and thrombocytopenia during the perinatal period. The patient subsequently developed a grade III SLH and received treatment involving cesarean section followed by laparoscopic hematoma evacuation. The fetus was rapidly delivered, with Apgar scores of 10 at 1, 5, and 10 minutes. And the patient recovered well after delivery.

This case provides a valuable idea for managing incidentally detected hepatic subcapsular hematoma rupture during cesarean delivery. This therapeutic strategy not only minimizes iatrogenic surgical trauma under the premise of ensuring maternal-fetal safety but also facilitates multidisciplinary collaboration and the accumulation of high-quality clinical evidence. Consequently, it furnishes a safe and effective therapeutic paradigm for the management of rare and life-threatening complications in obstetric practice.