Postpartum hepatic rupture and intestinal fistula associated with severe pre-eclampsia

Abstract

Here, the authors present a case of severe pre-eclampsia complicated by postpartum HELLP syndrome. A 29-year-old pregnant woman with severe pre-eclampsia at 30 weeks of gestation was admitted to the present clinic with hypertension and proteinuria. A cesarean section was performed at 31+3 weeks of gestation due to fetal distress and a history of cesarean section. The postpartum period was uneventful until two days after the cesarean section, when the patient began to experience epigastric pain, nausea, and vomiting. Subsequent laboratory tests were consistent with HELLP syndrome. Development of hemoperitoneum led to the patient being conveyed to surgery whereupon the authors discovered a large hematoma. They also identified that the liver capsule had a 5-cm tear. Unfortunately, the patient was diagnosed with an intestinal fistula 12 days after surgery. They therefore recommend that caution should be exercised closely monitoring for new symptoms in patients with pre-eclampsia in order to detect the potential development of postpartum HELLP syndrome.