A Rare Case of a Spontaneously Ruptured Hepatocellular Adenoma in the Third Trimester of Pregnancy

This case report details the management of a 29-year-old primigravida who presented at 35 weeks of gestation with abdominal pain and vomiting. The patient exhibited tachycardia and fetal bradycardia, with laboratory findings indicating severe anemia and elevated liver enzymes. An emergency cesarean section was performed due to hemodynamic instability, during which a ruptured hepatocellular adenoma (HCA) was discovered, necessitating an atypical left hepatectomy. Despite successful maternal recovery, the neonate succumbed to multiple organ failure. Hepatocellular adenomas (HCA), also known as hepatic adenomas, are rare benign epithelial liver tumors that predominantly occur in women during their reproductive years and have been strongly associated with the intake of oral contraceptives. This case highlights the rare occurrence of HCA rupture during pregnancy, emphasizing the importance of prompt diagnosis and intervention to prevent life-threatening complications. Additionally, it underscores the need for careful monitoring and potential preemptive intervention in pregnant women with large HCAs due to the elevated risk of rupture.