We herein present the first reported case of a pregnant patient with underlying pregnancy-induced hypertension and HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome who presented with hepatic rupture following a minor motor vehicle [ncbi.nlm.nih.gov]

• HELLP Syndrome

  The causes of hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome or hepatic hemorrhage as a serious complication of HELLP are not known. [ncbi.nlm.nih.gov]

• Amyloidosis

  In systemic amyloidosis spontaneous rupture of the liver is a rare complication. Here we report on a patient with unrecognized systemic amyloidosis who presented to an outside hospital with unspecific abdominal pain. [ncbi.nlm.nih.gov]

  Spontaneous rupture of the liver associated with amyloidosis. Journal of Clinical Gastroenterology. 1989; 11(1):85-87. PubMed | Google Scholar Cheung YS, Wong S, Lam PKN, Lee KF, Wong J, Lai PBS. [panafrican-med-journal.com]

• Abdominal Pain

  Hepatic rupture in HELLP syndrome should be considered a differential diagnosis in pregnant patients with sudden onset of abdominal pain or hypotension. [ncbi.nlm.nih.gov]

  A liver cyst that bleeds into the abdominal cavity can cause severe shoulder and abdominal pain in affected people, the Cleveland Clinic reports. [livestrong.com]

• Right Upper Quadrant Pain

  The clinical triad of toxemia, right upper quadrant pain, and sudden hypotension is the diagnostic hallmark of presentation. [ncbi.nlm.nih.gov]

  Patients usually present with severe right upper quadrant pain, abdominal distention, guarding, acute anemia or hypotension. Suspicion of injury is raised from presentation, physical examination and laboratory findings. [ejournal.tnmed.org]

  The clinical presentation of subcapsular hematoma is not characteristic; most patients present with right upper quadrant pain [ 1 ]. [panafrican-med-journal.com]

  She had worsening right upper quadrant pain and on examination the surgical site was clean with a tender right upper quadrant. Bedside ultrasound showed post operative changes without any hepatic abnormality or hemorrhage. [ispub.com]

  The clinical presentation of such patients is one of vague epigastric pain and / or right upper quadrant pain associated with nausea with or without vomiting. Such symptoms can easily be attributed to the original disease of preeclampsia. [saudijgastro.com]

• Acute Abdomen

  Abdomen in Pregnancy will serve practitioners as a quick-reference guide to those who encounter pregnant women in pain. [books.google.de]

  Ruptured giant liver cyst: a rare cause of acute abdomen in a haemodialysis patient with autosomal dominant polycystic kidney disease. Neth J Med. 2002;60:363–5. [surgicalcasereports.springeropen.com]

  The diagnosis of liver rupture must be included in the differential diagnosis of acute abdomen both antepartum and post-partum, especially in patients with severe preeclampsia. [saudijgastro.com]

• Abdominal Distension

  The SLH may present as right upper quadrant abdominal pain or shoulder pain, abdominal distension, nausea or vomiting. [casereports.in]

  […] clots by endoscopy 1 months, no symptoms [The present case] 65/F PCLD Dyspnea, abdominal distension Unknown Unknown − Left lateral segmentectomy, resection of the walls of the cysts 10 months, no symptoms Conclusions PCLD is a different disease from [surgicalcasereports.springeropen.com]

• Right Upper Quadrant Tenderness

  Physical examination showed significant right upper quadrant tenderness, soft abdomen with no guarding or rigidity and active bowel sounds, normal heart sounds with no murmurs or added sounds, and normal breath sounds. [hrjournal.net]

• Hypotension

  The patient had hypotension, falling hematocrit level, hepatomegaly, and evidence of progressive hepatocellular dysfunction. Hepatic dysfunction is not uncommon in rheumatoid arthritis, but is usually asymptomatic. [ncbi.nlm.nih.gov]

The workup at that time was consistent with an intra-abdominal abscess and a reactive pleural effusion, which are the known complications of liver embolization. [mdmag.com]

If possible, a premortem peripheral blood smear should be examined and the clinical workup reviewed. [captodayonline.com]

The underlying disorder can have a significant effect on morbidity and mortality in both mother and fetus, and a diagnostic workup should be initiated promptly. [clevelandclinicmeded.com]

Controversiality exists with regard to the treatment modality. [ncbi.nlm.nih.gov]

The cornerstone of prognosis is early diagnosis. Hepatic rupture in HELLP syndrome should be considered a differential diagnosis in pregnant patients with sudden onset of abdominal pain or hypotension. [ncbi.nlm.nih.gov]

Prognosis Malignant transformation is rare and the long-term prognosis is good. The documents contained in this web site are presented for information purposes only. [orpha.net]

In serious hepatic lesions, transplantation has been used, although these are exceptional situations. 6 Prognosis depends on the etiology, severity of the hemorrhage and the speed and efficacy of treatment. [elsevier.es]

In addition to pain and hemorrhagic shock, there is also a risk of peritoneal seeding of cancer cells, which worsen the prognosis. The diagnosis can be confirmed by the presence of hemoperitoneum on abdominal paracentesis. [hrjournal.net]

Though looking alarming, awareness of this entity and visualization with computed tomography can help to explain the prognosis to the patients Competing interests The authors declare no competing interests. [panafrican-med-journal.com]

Most series to date reported the incidence and characteristics of a single etiology. METHODS: Data were collected for all patients admitted with spontaneous hepatic rupture from 1995 to 2007. RESULTS: Ten patients met the study criteria. [ncbi.nlm.nih.gov]

The radiological and pathological studies ruled out other etiologies that would have explained the rupture. [elsevier.es]

Most series to date reported the incidence and characteristics of a single etiology. Data were collected for all patients admitted with spontaneous hepatic rupture from 1995 to 2007. Ten patients met the study criteria. [journals.lww.com]

Etiology In most cases, adenomas develop for unclear reasons in an otherwise healthy liver. [orpha.net]

A diagnosis of purulent pericarditis and pericardial tamponade secondary to transdiaphragmatic rupture of hepatic abscesses was made—the etiology of abscess formation was thought to be ascending infection via the cholecystostomy tube. [circ.ahajournals.org]

Summary Epidemiology Annual incidence is estimated at one case per million. Clinical description Mean age at diagnosis is 34 years (ranging from 15 to 64 years). HA rarely occurs in children. [orpha.net]

EPIDEMIOLOGY According to the case report and literature review by Vokaer et al[ 8 ], since 1898 when Van Haefen described the first case of spontaneous rupture of a liver hemangioma, only 33 cases of ruptured hemangioma in adults have been reported in [wjgnet.com]

Pathophysiology, epidemiology, classification and treatment options for polycystic liver diseases. World J Gastroenterol. 2013;19:5775–86. [surgicalcasereports.springeropen.com]

Underlying pathophysiology of preeclampsia? Cure? Vasospasm and "leaky vessels" which cause local hypoxemia. Hypoxemia leads to hemolysis, necrosis, and end organ damage End of pregnancy (Usually delivery) Complications of preeclampsia? 1. [brainscape.com]

Pathophysiology, epidemiology, classification and treatment options for polycystic liver diseases. World J Gastroenterol. 2013;19:5775–86. [surgicalcasereports.springeropen.com]

The pathophysiology of this condition is complex and poorly understood. The origin of pre-eclampsia/HELLP can be attributed to defective trophoblastic invasion. [wjes.biomedcentral.com]

It typically arises in the third trimester of pregnancy, although it has been reported as early as 13 weeks' gestation. 18 – 20 The pathophysiology of intrahepatic cholestasis of pregnancy remains poorly understood. 19 Pruritus alone occurs in 80 percent [aafp.org]

There are no clinical markers that predict the course of a pregnancy and the pathophysiologic mechanisms are not always understood, but knowledge and management of the preconception liver disease and efficacious pre-pregnancy and prenatal care are essential [clevelandclinicmeded.com]

Early initiation of anticoagulation is both safe and effective in preventing APAS complications. Aspirin should be initiated to prevent future thrombosis and pregnancy loss. [lupus.bmj.com]

Sometimes there is bleeding at the staple line Continued Can Bleeding Varices Be Prevented? Treating the underlying cause of bleeding varices can help prevent their return. Earlier treatment of liver disease may prevent them from developing. [webmd.com]

What Can I Do to Prevent HELLP Syndrome? Unfortunately, there's currently no way to prevent this illness. [preeclampsia.org]

Many of these women are sexually active and do not take effective measures to prevent pregnancy. [clevelandclinicmeded.com]

The dyspnea had prevented her from sleeping for several days. She had hypertension and underwent laparoscopic cholecystectomy for cholecystitis 20 years earlier. She denied history of trauma. [surgicalcasereports.springeropen.com]