J Korean Soc Radiol.  2013 May;68(5):407-410.

Hepatic Rupture Caused by Hemolysis, Elevated Liver Enzyme, and Low Platelet Count Syndrome: A Case Report with Computed Tomographic and Conventional Angiographic Findings

• Lee CB
• Ahn JH
• Choi SJ
• Lee JH
• Park MS
• Jung SM
• Ryu DS

Abstract

The authors recently obtained successful clinical outcome after embolization of the hepatic artery and right inferior phrenic artery in a pregnant patient with hemolysis, elevated liver enzyme, and low platelet count (HELLP) syndrome causing hepatic rupture. We report the computed tomographic and conventional angiographic findings in a case of HELLP syndrome, resulting in hepatic infarction and rupture with active bleeding.

MeSH Terms

Angiography
Arteries
Blood Platelets
Female
HELLP Syndrome
Hemolysis
Hemorrhage
Hepatic Artery
Humans
Infarction
Liver
Platelet Count
Pregnancy
Rupture

Figure

• 

  Fig. 1 A 28-year pregnant woman with HELLP syndrome. A. Axial contrast-enhanced CT reveals active contrast extravasation (arrow) in peripheral right hepatic lobe. B. Axial contrast-enhanced CT reveals active contrast extravasation (long arrow) in right central hepatic lobe near to bare area. The liver surface shows the irregular interface (short arrows) between subcapsular hematoma (asterisk) and necrotic hepatic parenchyma (clover) presumably representing hepatic rupture. C. Conventional hepatic angiography shows multiple contrast extravasations (arrows) from posterior segmental branch of liver. The right hepatic surface is compressed by subcapsular hematoma. D. Right inferior phrenic angiography shows contrast extravasations (arrows). E. Follow-up axial contrast-enhanced CT two months after embolization shows large post-hemorrhagic pseudocyst formation (asterisk) in necrotic right lobe of liver and perihepatic space. The embolization coil (arrow) in right inferior phrenic artery is visible. Note.-HELLP = hemolysis, elevated liver enzyme, and low platelet count

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