Gynäkologie und Geburtshilfe
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Severe Hepatic Rupture after Cesarean Section for Help Syndrome followed by Multiple Laparotomies: A Teaching Case

Gianluca Raffaello Damiani, Gianmaria Confalonieri, Luca Fumagalli, Paolo Faccioli, Alfredo Galluzzi and Antonio Pellegrino

A successful management of hepatic capsular rupture, with massive hemoperitoneum occurred 15 hours after an emergency cesarean section at 36 week’ gestation is meticulously descripted. The grade of hepatic involvement varies from minor capsular laceration to extensive parenchymal rupture. Our management involved a combination of surgical interventions and aggressive supportive care. The patient was discharged after 54 days and 4 laparotomies and a super-selective artery embolization. Ultrasound after 45 days from the last surgery showed uniform hepatic parenchyma free of focal lesions. Due to the rarity and the unpredictability nature of this devastating event we retain necessary to report our experience, reinforcing the importance of the post-surgery management.