Hepatic infarct complicating HELLP syndrome

Case contributed by Youssef Sakhy
Diagnosis almost certain


Right upper quadrant abdominal pain. Day 1 after cesarean section for pre-eclampsia and HELLP syndrome.

Patient Data

Age: 35 years
Gender: Female

CT scan shows patches of poorly defined non-enhancing areas of the right liver lobe , compatible with hepatic infarct given the context.

Peritoneal fluid with small right-sided pleural effusion.

Post-operative uterine changes with pneumoperitoneum.

Case Discussion

HELLP syndrome is an uncommon pregnancy-related condition characterized by hemolysis, elevated liver enzymes and low platelets, affecting 0.2% of all pregnancies1.

Hepatic infarction is a complication of HELLP syndrome, rare due to the dual vascular supply of the liver, its pathogenesis remains unclear but regional vasospasm is the most probable cause.

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