Hepatic rupture secondary to pre-eclampsia--report of a case treated conservatively

Hepatic rupture during pregnancy is related to toxaemia and is most often fatal. Epigastric pain and signs of intra-abdominal bleeding are the most common presenting symptoms. In previous reports liver surgery has been considered the method of choice in all patients. However, we have successfully treated a patient with bilateral hepatic rupture and intra-thoracic bleeding with termination of the pregnancy but otherwise conservative measures. The importance of early diagnosis, by ultrasonography and/or explorative laparotomy, and early termination of the pregnancy is stressed. Also, it is suggested that liver surgery should be individually tailored and that it is preferably avoided in some patients.