Unexpected Subcapsular Hepatic Hematoma Rupture in HELLP Syndrome: A Case Report
Essaidi Zakaria, El Azhari Ilias, MASTAR Hajar, Ettaoussi Abdelhak, Kamal Khadija, Majd Abdessamad, Bouali Mounir, EL BAKOURI Abdelillah, El hattabi Khalid, BENCHRIFI Yassine, WAJIH Oumeima, KAROUANI Doha
Asian Journal of Research in Surgery · pp. 23–27 · Published 19 Jan 2026
10.9734/ajrs/2026/v9i1341Abstract
The HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) is considered a severe condition that may occur during pregnancy, carrying significant maternal and fetal risks. It can lead to multiple complications, including subcapsular liver hematoma (SLH), a potentially fatal consequence due to the risk of rupture. We report the case of a 27-year-old primigravida at 32 weeks of gestation, who presented with acute abdominal pain and hemodynamic instability. Laboratory findings confirmed HELLP syndrome, and a ruptured subcapsular liver hematoma was suspected. An emergency cesarean section was performed without prior imaging, revealing massive hemoperitoneum and intrauterine fetal death. Further surgical exploration confirmed a ruptured SLH with active bleeding. Therefore, a perihepatic packing was performed. This case underscores the need for high clinical suspicion and rapid multidisciplinary intervention, as SLH rupture remains a rare but devastating complication of HELLP syndrome.
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