Spontaneous Rupture of a Liver Subcapsular Haematoma during Pregnancy Ruptura Espontânea De Hematoma Subcapsular Hepático Na Gravidez

We report the case of a 37 years-old nulliparous woman who developed HELLP (Hemolysis Elevated Liver Enzymes Low Platelets) syndrome with intense upper abdominal pain during the 27th week of pregnancy. A subcapsular right liver lobe haematoma and a large peritoneal effusion were identified on ultrasound. Fetal extraction was carried out by caesarean section, during which liver exploration revealed a ruptured subcapsular haematoma which was coagulated with Argon LASER. Recovery was slow, and re-absorption of the haematoma was documented by serial imagiological exams. Although rare, ruptured subcapsular liver haematoma should be considered in pregnant women presenting with upper abdominal pain and signs of hemorrhagic shock.