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Hepatic hemorrhage and the HELLP syndrome: a surgeon's perspective.
Am Surg. 1995 Sep; 61(9):756-60.AS

Abstract

Hypertension-induced hepatic disease is a common cause of abdominal pain and liver function test abnormalities in the pregnant patient. Liver hemorrhage and rupture, in turn, are the most unusual and serious complications of preeclamptic/eclamptic or HELLP (Hemolysis Elevated Liver enzymes and Low Platelet count) associated disease. Should a liver hematoma be documented, management must be aggressive, with treatment of hypertension, correction of any coagulopathy, and prompt delivery of the child. Rupture remains a surgical emergency with control of bleeding based on trauma principles. Postoperative care is difficult, with a propensity toward multiple system organ failure. With an aggressive multidisciplinary approach to the management of these patients, mortality rates have been decreased by fifty per cent. Subsequent pregnancies appear to carry no increased risk of liver rupture over the general population but should be followed carefully by a high-risk obstetrician.

Authors+Show Affiliations

Stevenson JT
Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Graham DJ
No affiliation info available

MeSH

AdultEmergenciesFemaleHELLP SyndromeHematomaHemorrhageHumansLiver DiseasesPregnancyRupture, Spontaneous

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

7661469

Citation

Stevenson, J T., and D J. Graham. "Hepatic Hemorrhage and the HELLP Syndrome: a Surgeon's Perspective." The American Surgeon, vol. 61, no. 9, 1995, pp. 756-60.
Stevenson JT, Graham DJ. Hepatic hemorrhage and the HELLP syndrome: a surgeon's perspective. Am Surg. 1995;61(9):756-60.
Stevenson, J. T., & Graham, D. J. (1995). Hepatic hemorrhage and the HELLP syndrome: a surgeon's perspective. The American Surgeon, 61(9), 756-60.
Stevenson JT, Graham DJ. Hepatic Hemorrhage and the HELLP Syndrome: a Surgeon's Perspective. Am Surg. 1995;61(9):756-60. PubMed PMID: 7661469.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hepatic hemorrhage and the HELLP syndrome: a surgeon's perspective. AU - Stevenson,J T, AU - Graham,D J, PY - 1995/9/1/pubmed PY - 1995/9/1/medline PY - 1995/9/1/entrez SP - 756 EP - 60 JF - The American surgeon JO - Am Surg VL - 61 IS - 9 N2 - Hypertension-induced hepatic disease is a common cause of abdominal pain and liver function test abnormalities in the pregnant patient. Liver hemorrhage and rupture, in turn, are the most unusual and serious complications of preeclamptic/eclamptic or HELLP (Hemolysis Elevated Liver enzymes and Low Platelet count) associated disease. Should a liver hematoma be documented, management must be aggressive, with treatment of hypertension, correction of any coagulopathy, and prompt delivery of the child. Rupture remains a surgical emergency with control of bleeding based on trauma principles. Postoperative care is difficult, with a propensity toward multiple system organ failure. With an aggressive multidisciplinary approach to the management of these patients, mortality rates have been decreased by fifty per cent. Subsequent pregnancies appear to carry no increased risk of liver rupture over the general population but should be followed carefully by a high-risk obstetrician. SN - 0003-1348 UR - https://www.unboundmedicine.com/medline/citation/7661469/Hepatic_hemorrhage_and_the_HELLP_syndrome:_a_surgeon's_perspective_ L2 - http://www.diseaseinfosearch.org/result/3266 DB - PRIME DP - Unbound Medicine ER -