Spontaneous liver rupture in a pregnant woman associated with HELLP syndrome
https://doi.org/10.16931/1995-5464.20193132-138
Abstract
Spontaneous liver rupture is rare and highly dangerous, life-threatening condition occurring in 1–2% of pregnant women with preeclampsia and eclampsia. There are more than 100 similar case reports in the literature. It is believed that liver rupture is caused by HELLP syndrome as one of the signs of preeclampsia. The results of surgical treatment is still unsatisfactory. Appropriate treatment strategy is absent because of rareness of this condition. It is presented case report of a woman with spontaneous liver rupture associated with HELLP syndrome. Patient underwent perihepatic tamponade, endovascular embolization of right hepatic artery followed by right-sided hemihepatectomy.
About the Authors
T. M. Bunyatov
Vishnevsky National Medical Research Center for Surgery
Russian Federation
Timur M. Bunyatov – General Surgery Resident
Russian Federation
Timur M. Bunyatov – General Surgery Resident
I. A. Kozlov
Vishnevsky National Medical Research Center for Surgery
Ilya A. Kozlov – Doct. of Sci. (Med.), Head of the Department of Surgical Oncology and Chemotherapy
Ilya A. Kozlov – Doct. of Sci. (Med.), Head of the Department of Surgical Oncology and Chemotherapy
B. N. Gurmikov
Vishnevsky National Medical Research Center for Surgery
Beslan N. Gurmikov – Cand. of Sci. (Med.), Surgeon of the Department of Surgical Oncology and Chemotherapy
Beslan N. Gurmikov – Cand. of Sci. (Med.), Surgeon of the Department of Surgical Oncology and Chemotherapy
Yu. A. Stepanova
Vishnevsky National Medical Research Center for Surgery
Yulia A. Stepanova – Doct. of Sci. (Med.), Scientific Secretary
Yulia A. Stepanova – Doct. of Sci. (Med.), Scientific Secretary
V. S. Shirokov
Vishnevsky National Medical Research Center for Surgery
Vadim S. Shirokov – Senior Research Fellow of the Department of Radiology and MRI
Vadim S. Shirokov – Senior Research Fellow of the Department of Radiology and MRI
V. A. Vishnevsky
Vishnevsky National Medical Research Center for Surgery
Vladimir A. Vishnevsky – Doct. of Sci. (Med.), Professor, Advisor of Director
27, Bolshaya Serpukhovskaya str., Moscow, 117997. Phone: +7-985-762-35.
References
1. Wicke C., Pereira P.L., Neeser E., Flesch I., Rodegerdts E.A., Becker H.D. Subcapsular liver hematoma in HELLP syndrome: evaluation of diagnostic and therapeutic options – a unicenter study. Am. J. Obstet. Gynecol. 2004; 190 (1): 106–112.
2. Vigil-De Gracia P. Maternal deaths due to eclampsia and HELLP syndrome. Int. J. Gynecol. Obst. 2009; 104 (2): 90–94. http://doi.org/10.1016/j.ijgo.2008.09.014.
3. Weinstein L. Syndrome of hemolysis, elevated liver enzymes, and low platelet count: a severe consequence of hypertension in pregnancy. Am. J. Obstet. Gynecol. 1982; 142 (2): 159–167.
4. Ong G.B., Taw J.L. Spontaneous rupture of hepatocellular carcinoma. Br. Med. J. 1972; 4 (5833): 146–149.
5. Chearanai O., Plengvanit U., Asavanich C., Damrongsak D., Sindhvananda K. Spontaneous rupture of primary hepatoma: report of 63 cases with particular reference to the pathogenesis and rationale treatment by hepatic artery ligation. Cancer. 1983; 51 (8): 1532–1536.
6. Andersson R., Tranberg K.G., Bengmark S. Hemoperitoneum after spontaneous rupture of liver tumor: results of surgical treatment. HPB Surgery. 1988; 1 (1): 81–83.
7. Cozzi P.J., Morris D.L. Two cases of spontaneous liver rupture and literature review. HPB Surgery. 1996; 9 (4): 257–260.
8. Abercrombie J. Hemorrhage of the liver. Lond. Med. Gaz. 1844; 34: 792–794.
9. Vigil-De G.P., Ortega-Paz L. Pre-eclampsia/eclampsia and hepatic rupture. Int. J. Gynecol. Obst. 2012; 118 (3): 186–189. http://doi.org/10.1016/j.ijgo.2012.03.042.
10. Ionkin D.A., Ikramov R.Z., Vishnevskiy V.A., Kabanova T.I., Zhavoronkova O.I., Kovalenko Z.A. A Spontaneous subcapsular liver hematoma in HELLP syndrome patient. Annaly khirurgicheskoy gepatologii = Annals of HPB surgery. 2011; 16 (3): 106–109. (In Russian)
11. Zangemeister W. Die Lehre von der Eklampsie auf Grund eigener Untersuchungen dargestellt. Verlag: S. Hirzel, Leipzig, 1926; 44 p.
12. Nelson E.W., Archibald L., Albo D. Spontaneous hepatic rupture in pregnancy. Am. J. Surg. 1977; 134 (6): 817–820.
13. Hunter S.K., Martin M., Benda J.A., Zlantik F.J. Liver transplant after massive spontaneous hepatic rupture in pregnancy complicated by preeclampsia. Obstet. Gynecol. 1995; 85 (5 Pt. 2): 819–822.
14. Mascarenhas R., Mathias J., Varadarajan R., Geoghegan J., Traynor Mr.O. Spontaneous hepatic rupture: a report of five cases. HPB (Oxford). 2002; 4 (4): 167–170. http://doi.org/10.1080/13651820260503819.
15. Nunes J.O., Turner M.-A., Fulcher A.S. Abdominal imaging features of HELLP syndrome: A 10-year retrospective review. Am. J. Roentgenol. 2005; 185 (5): 1205–1210. http://doi.org/10.2214/AJR.04.0817.
16. Suarez B., Alves K., Senat M.V., Fromageot J., Fischer C., Rosenberg P., Ville Y. Abdominal pain and preeclampsia: sonographic findings in the maternal liver. J. Ultrasound. Med. 2002; 21 (10): 1077–1083.
17. Stepanova Yu.A., Borsukov A.V., Panchenkov D.N. Ultrasoundassisted percutaneous hepatopancreatobiliary and splenic interventions. Part I. Percutaneous interventions on the liver. Diagnostic and Interventional Radiology. 2009; 3 (1): 55–77. (In Russian)
18. Domadia N., Bheda H., Modiya S., Raychaudhari C. Role of CT scan in diagnosis of HELLP syndrome: Radiologist’s perspective. IAIM. 2017; 4 (2): 60–63.
19. Yagmurdur M.C., Agalar F., Daphan C.E. Spontaneous hepatic rupture in pregnancy. Eur. J. Emerg. Med. 2000; 7 (1): 75–76.
20. Smith L.G., Moise K.J., Dildy G.A., Carpenter R.J. Spontaneous rupture of liver during pregnancy: Current therapy. Obstet. Gynecol. 1991; 77 (2): 171–175.
21. Gutovich J.M., Van Allan R.J. Hepatic artery embolization for hepatic rupture in HELLP syndrome. J. Vasc. Interv. Radiol. 2016; 27 (12): 1931–1933. http://doi.org/10.1016/j.jvir.2016.08.003.
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For citations:
Bunyatov T.M., Kozlov I.A., Gurmikov B.N., Stepanova Yu.A., Shirokov V.S., Vishnevsky V.A. Spontaneous liver rupture in a pregnant woman associated with HELLP syndrome. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2019;24(3):132-138. (In Russ.) https://doi.org/10.16931/1995-5464.20193132-138
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