Spontaneous intrahepatic hemorrhage and hepatic rupture in the HELLP syndrome: Four cases and a review

Rafiq A. Sheikh, Shagufta Yasmeen, Mary Pat Pauly, Jonathan L. Riegler

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66 Scopus citations


Subcapsular hemorrhage and hepatic rupture are unusual catastrophic complications of the HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome. A high index of suspicion and prompt recognition are keys to proper diagnosis and management of affected patients. The optimal management of these patients is evolving. An aggressive multidisciplinary approach has considerably improved the morbidity and mortality associated with these complications. We present our experience with four cases of hepatic hemorrhage occurring in association with the HELLP syndrome and review the literature on this subject. All of our patients were multiparous, and three had a history of eclampsia/preeclampsia in a previous pregnancy. All four patients developed intrahepatic hemorrhage; two developed hepatic rupture requiring surgical intervention. Three patients developed disseminated intravascular coagulation and acute renal failure. Two patients developed pericardial effusion, pleural effusions, and ascites. One patient died of septic complications after multiple surgical interventions.

Original languageEnglish (US)
Pages (from-to)323-328
Number of pages6
JournalJournal of Clinical Gastroenterology
Issue number4
StatePublished - Jun 1999


  • HELLP syndrome
  • Hepatic rupture
  • Intrahepatic hemorrhage
  • Subcapsular hematoma

ASJC Scopus subject areas

  • Gastroenterology


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