An Intraoperative Diagnosis of Ruptured Subcapsular Liver Hematoma Secondary to HELLP syndrome: A case report

Abstract

Subcapsular liver hematoma (SLH) though rare, poses a significant risk to maternal health in patients diagnosed with HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome. We report a case of a 29-year-old Gravida 4, Para 2+1 woman at 31weeks gestation who presented with upper abdominal pain, nausea and vomiting. Intraoperative findings during an emergency caesarean for fetal compromise revealed a ruptured subcapsular liver hematoma. The patient underwent a successful surgical management and had an uneventful recovery. This case emphasizes the importance of a high index of suspicion for SLH in pregnant women with HELLP syndrome presenting with right upper quadrant or epigastric pain.