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Spontaneous hepatic rupture in pregnancy or the puerperium is an extremely rare and life-threatening condition. We present a case in which the patient initially presented with intrahepatic cholestasis of pregnancy and shortly after delivery developed acute spontaneous hepatic rupture. Unlike most other cases, the patient never developed a fulminant syndrome of hemolysis, elevated liver enzymes and low platelet count (HELLP). Early recognition of the syndrome, an aggressive surgical approach with cesarean section and liver packing and blood component therapy contributed to a successful outcome and admission of 27 days.
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Boyer TD, Wright TL, Manns MP. Zakim and Boyer’s Hepatology. 6th ed. London: Elsevier - Health Sciences Division; 2011.
Augustin G, Hadzic M, Juras J, Oreskovic S. Hypertensive disorders in pregnancy complicated by liver rupture or hematoma: a systematic review of 391 reported cases. World Journal of Emergency Surgery. 2022 Dec 1;17(1). DOI: https://doi.org/10.1186/s13017-022-00444-w
Ristorp Andersen B, Bergholt T, Erdberg P, Hvidman L, Sharif H, Weber T, et al. DSOG National Clinical Guidelines: Leverbetinget graviditetskløe Intrahepatic cholestasis of Pregnancy; ICP. 2022.
Nielsen LH, Sundtoft I, Vestgaard MJ, Persson L, Storgaard L, Pedersen W, et al. DSOG National Clinical Guidelines: Hypertension og praeeklampsi. 2018.
Lefebvre CW, Babich JP, Grendell JH, Grendell JH, Heffner JE, Thibault R, et al. Encyclopedia of Intensive Care Medicine: Pringle Maneuver [Internet]. Encyclopedia of Intensive Care Medicine. Springer, Berlin, Heidelberg; 2012 [cited 2023 Feb 24]. 1847–1850 p. Available from: https://link.springer.com/referenceworkentry/10.1007/978-3-642-00418-6_505
Nielsen PH, Jepsen SB, Olsen AD. Postoperative pleural effusion following upper abdominal surgery. Chest. 1989;96(5):1133–5. DOI: https://doi.org/10.1378/chest.96.5.1133