Liver Subcapsular Hematoma Conservative Treatment in HELLP (Hemolysis, Elevated Liver Enzymes, and Low Platelet Count) Syndrome: A Case Report

Subcapsular hepatic hematoma is a life-threatening complication during pregnancy. Conservative treatment could be possible with an equipped unit and a fully staffed team available 24 hours a day. We present the case of a 40-year-old patient at 37 weeks of gestation with preeclampsia meeting severe features who presented with diffuse abdominal pain radiating to the right shoulder. In a private hospital, during a cesarean section, hepatic bleeding was observed. In our hospital, partial HELLP (Hemolysis, Elevated liver enzymes, and Low Platelet count) syndrome was diagnosed, and treatment began. Once stabilized, a CT scan revealed two subcapsular hepatic hematomas with a total volume of 1700 cc. The multidisciplinary team adopted a conservative management approach, incorporating close clinical and biochemical follow-up. After 25 days, the patient was discharged home with a significant reduction in the size of both hematomas.