A case of video-assisted retroperitoneal debridement in a patient with HELLP syndrome.
Hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome describes a cohort of disease processes that may have devastating consequences for the peripartum patient. Although the hemopoetic and hepatic systems are classically involved, we illustrate a case of walled-off pancreatic necrosis occurring in a woman with HELLP syndrome. Initially managed with resuscitation, steroids, and plasmapheresis, the patient developed necrotizing pancreatitis that overtime became walled-off. Despite attempts at percutaneous drainage, the patient ultimately had a video-assisted retroperitoneal debridement. As there are no descriptions in the literature of walled-off pancreatic necrosis stemming from HELLP syndrome, this case provides a new avenue from which to study the pathophysiology and provides a management strategy for this problem.
Department of Surgery, Georgetown University Hospital, Washington, DC 20007, USA. JAY.A.GRAHAM@gunet.georgetown.edu
Jay A
JA
Graham
Brenton R
BR
Franklin
Patrick G
PG
Jackson
D000328:Adult; D001442:Bacteroides Infections / Q000175:diagnosis; D003646:Debridement / Q000379:methods; D005260:Female; D017359:HELLP Syndrome; D006801:Humans; D019283:Pancreatitis, Acute Necrotizing / Q000382:microbiology / Q000601:surgery*; D010537:Peritoneum / Q000601:surgery; D011247:Pregnancy; D059285:Pregnancy, Twin; D011644:Puerperal Disorders / Q000382:microbiology / Q000601:surgery*; D020535:Video-Assisted Surgery / Q000379:methods*