title: Management of Spontaneous Hepatic Rupture on Top of HELLP Syndrome: Case Report and Review of the Literature.
abstract: BACKGROUND
  We report the case of a patient with antepartum HELLP syndrome and simultaneous rupture of the right liver lobe. An emergency caesarean section was performed and the liver rupture was managed surgically via perihepatic packing. The mother and her child recovered well and were discharged 19 days after admission.
  
  
  METHODS
  We describe a case report and review the literature. Based on our own experience and the most common clinical presentations of such patients, we were able to establish an algorithm for managing such cases.
  
  
  CONCLUSIONS
  An association between liver rupture and HELLP syndrome is rare but was previously described in several case reports. In pregnant women with HELLP syndrome and acute onset abdominal pain, a potential spontaneous hepatic rupture should be taken into consideration.
authors.affiliation: University Department of General and Visceral Surgery, Klinikum Oldenburg, Oldenburg, Germany.
authors.forename: Achim
authors.initials: A
authors.lastname: Troja
authors.affiliation: University Department of General and Visceral Surgery, Klinikum Oldenburg, Oldenburg, Germany.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abdou
authors.affiliation: University Department of Obstetrics and Gynecology, Klinikum Oldenburg, Oldenburg, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Rapp
authors.affiliation: University Department of General and Visceral Surgery, Klinikum Oldenburg, Oldenburg, Germany.
authors.forename: Swantje
authors.initials: S
authors.lastname: Wienand
authors.affiliation: University Department of Obstetrics and Gynecology, Klinikum Oldenburg, Oldenburg, Germany.
authors.forename: Eduard
authors.initials: E
authors.lastname: Malik
authors.affiliation: University Department of General and Visceral Surgery, Klinikum Oldenburg, Oldenburg, Germany.
authors.forename: Hans-Rudolf
authors.initials: HR
authors.lastname: Raab
keywords: Caesarean section; HELLP syndrome; Liver rupture; Perihepatic packing