<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0186-4866</journal-id>
<journal-title><![CDATA[Medicina interna de México]]></journal-title>
<abbrev-journal-title><![CDATA[Med. interna Méx.]]></abbrev-journal-title>
<issn>0186-4866</issn>
<publisher>
<publisher-name><![CDATA[Edición y Farmacia S.A. de C.V.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0186-48662019000200302</article-id>
<article-id pub-id-type="doi">10.24245/mim.v35i2.2119</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Hematomas hepáticos subcapsulares posparto en síndrome HELLP]]></article-title>
<article-title xml:lang="en"><![CDATA[Postpartum subcapsular hepatic hematomas in HELLP syndrome]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López-Islas]]></surname>
<given-names><![CDATA[Inés]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cerda-Ángeles]]></surname>
<given-names><![CDATA[Juan Carlos De la]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Maxil-Sánchez]]></surname>
<given-names><![CDATA[Abraham Juan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vásquez-Vásquez]]></surname>
<given-names><![CDATA[Juan Ernesto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Secretaría de Salud Hospital General Dr. Enrique Cabrera ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Secretaría de Salud Hospital General Dr. Enrique Cabrera ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2019</year>
</pub-date>
<volume>35</volume>
<numero>2</numero>
<fpage>302</fpage>
<lpage>307</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0186-48662019000200302&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0186-48662019000200302&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0186-48662019000200302&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: El síndrome HELLP es una complicación del embarazo que puede ser mortal cuando sobreviene hematoma hepático subcapsular o ruptura hepática, su tratamiento puede ser conservador, embolización de la arteria hepática, drenaje quirúrgico e incluso trasplante hepático. Se comunica el caso de una paciente de 37 años de edad, multípara, que tuvo preeclampsia y en el posparto hematomas hepáticos subcapsulares que requirió inicialmente manejo conservador, posteriormente embolización supraselectiva de la arteria hepática derecha y finalmente laparotomía exploradora con drenaje de hematomas y colecistectomía abierta por necrosis vesicular, así como vigilancia por hematomas hepáticos residuales posquirúrgicos. Fue egresada estable en términos cardiohemodinámicos y respiratorios. Establecer de forma oportuna el diagnóstico y tratamiento del hematoma hepático subcapsular en pacientes con síndrome HELLP puede disminuir la mortalidad; la vigilancia clínica, bioquímica y con estudios de imagen es importante.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Hellp syndrome is a complication of pregnancy that can be fatal when subcapsular hepatic hematoma or hepatic rupture occurs, its management can be conservative or can include embolization of the hepatic artery, surgical drainage and even liver transplantation. This paper reports the case of a 37-year-old multiparous patient who presented preeclampsia and in the postpartum hepatic subcapsular hematomas that initially required conservative management, later supraselective embolization of the right hepatic artery and finally exploratory laparotomy with drainage of hematomas and open cholecystectomy due to vesicular necrosis, as well as surveillance for post-surgical residual hepatic hematomas. She was discharged stable in cardiohemodynamic and respiratory terms. The timely diagnosis and treatment of subcapsular hepatic hematoma in patients with HELLP syndrome can reduce mortality; clinical, biochemistry and imaging studies monitoring are important.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Síndrome HELLP]]></kwd>
<kwd lng="es"><![CDATA[hematoma]]></kwd>
<kwd lng="es"><![CDATA[hepático]]></kwd>
<kwd lng="es"><![CDATA[subcapsular]]></kwd>
<kwd lng="es"><![CDATA[preeclampsia]]></kwd>
<kwd lng="es"><![CDATA[necrosis]]></kwd>
<kwd lng="en"><![CDATA[HELLP syndrome]]></kwd>
<kwd lng="en"><![CDATA[Hematoma]]></kwd>
<kwd lng="en"><![CDATA[Hepatic]]></kwd>
<kwd lng="en"><![CDATA[Subcapsular]]></kwd>
<kwd lng="en"><![CDATA[Preeclampsia]]></kwd>
<kwd lng="en"><![CDATA[Necrosis]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wicke]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Pereira]]></surname>
<given-names><![CDATA[PL]]></given-names>
</name>
<name>
<surname><![CDATA[Neeser]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Flesch]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Rodegerdts]]></surname>
<given-names><![CDATA[EA]]></given-names>
</name>
<name>
<surname><![CDATA[Becker]]></surname>
<given-names><![CDATA[HD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Subcapsular liver hematoma in HELLP syndrome Evaluation of diagnostic and therapeutic options--a unicenter study]]></article-title>
<source><![CDATA[Am J Obstet Gynecol]]></source>
<year>2004</year>
<volume>190</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>106-12</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sibai]]></surname>
<given-names><![CDATA[BM]]></given-names>
</name>
<name>
<surname><![CDATA[Ewell]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Levine]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Klebanoff]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Esterlitz]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Catalano]]></surname>
<given-names><![CDATA[PM]]></given-names>
</name>
<name>
<surname><![CDATA[Goldenberg]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
<name>
<surname><![CDATA[Joffe]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk factors associated with preeclampsia in healthy nulliparous women The Calcium for Preeclampsia Prevention (CPEP) Study Group]]></article-title>
<source><![CDATA[Am J Obstet Gynecol]]></source>
<year>1997</year>
<volume>177</volume>
<page-range>1003-10</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Abercombie]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Case of hemorrhage of the liver]]></article-title>
<source><![CDATA[London Medical Gazzette]]></source>
<year>1844</year>
<volume>34</volume>
<page-range>792</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ndzengue]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Hammoudeh]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Brutus]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[An obscure case of hepatic subcapsular hematoma]]></article-title>
<source><![CDATA[Case Reports Gastroenterol]]></source>
<year>2011</year>
<volume>5</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>223-6</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Carlson]]></surname>
<given-names><![CDATA[KL]]></given-names>
</name>
<name>
<surname><![CDATA[Bader]]></surname>
<given-names><![CDATA[CL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ruptured subcapsular liver hematoma in pregnancy a case report of nonsurgical management]]></article-title>
<source><![CDATA[Am J Obstet Gynecol]]></source>
<year>2004</year>
<volume>190</volume>
<page-range>558-60</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cernea]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Dragoescu]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Novac]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[HELLP syndrome complicated with postpartum subcapsular ruptured liver hematoma and purtscher-like retinopathy]]></article-title>
<source><![CDATA[Case Rep Obstet Gynecol]]></source>
<year>2012</year>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sheikh]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Yasmeen]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Paul y]]></surname>
<given-names><![CDATA[MP]]></given-names>
</name>
<name>
<surname><![CDATA[Riegler]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Spontaneous intrahepatic hemorrhage and hepatic rupture in the HELLP syndrome Four cases and a review]]></article-title>
<source><![CDATA[J Clin Gastroenterol]]></source>
<year>1999</year>
<volume>28</volume>
<page-range>323-8</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mohr]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Lavery]]></surname>
<given-names><![CDATA[RF]]></given-names>
</name>
<name>
<surname><![CDATA[Barone]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Angiografhic embolization for livers injuries low mortality, high morbidity]]></article-title>
<source><![CDATA[J Trauma]]></source>
<year>2003</year>
<volume>55</volume>
<page-range>1077-81</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Miguelote]]></surname>
<given-names><![CDATA[RF]]></given-names>
</name>
<name>
<surname><![CDATA[Costa]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Vivas]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Gonzaga]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Alpoim Menezes]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Postpartum spontaneous rupture of a liver hematoma associated with preeclampsia and HELLP syndrome]]></article-title>
<source><![CDATA[Arch Gynecol Obstet]]></source>
<year>2009</year>
<volume>279</volume>
<page-range>923-6</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hunter]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
<name>
<surname><![CDATA[Martin]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Benda]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Zlantnik]]></surname>
<given-names><![CDATA[FJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Liver transplant after massive spontaneous hepatic rupture in pregnancy complicated by preeclampsia]]></article-title>
<source><![CDATA[Obstet Gynecol]]></source>
<year>1995</year>
<volume>85</volume>
<page-range>819-22</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Reed]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
<name>
<surname><![CDATA[Merrell]]></surname>
<given-names><![CDATA[Rc]]></given-names>
</name>
<name>
<surname><![CDATA[Meyers]]></surname>
<given-names><![CDATA[WC]]></given-names>
</name>
<name>
<surname><![CDATA[Fischer]]></surname>
<given-names><![CDATA[RP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Continuing evolution in the approach to severe liver trauma]]></article-title>
<source><![CDATA[Ann Surg]]></source>
<year>1992</year>
<volume>216</volume>
<page-range>524-38</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Olivares]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Valdés]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Millán]]></surname>
<given-names><![CDATA[MP]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hígado graso agudo del embarazo, una patología infradiagnosticada A propósito de 2 casos clínicos]]></article-title>
<source><![CDATA[Prog Obstet Ginecol]]></source>
<year>2015</year>
<volume>58</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>81-7</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Ghaziani]]></surname>
<given-names><![CDATA[TT]]></given-names>
</name>
<name>
<surname><![CDATA[Wolf]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acute fatty liver disease of pregnancy Updates in pathogenesis, diagnosis and management]]></article-title>
<source><![CDATA[Am J Gastroenterol]]></source>
<year>2017</year>
<volume>112</volume>
<page-range>838-46</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Neave]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Scully]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Microangiopathic hemolytic anemia in pregnancy]]></article-title>
<source><![CDATA[Transfus Med Rev]]></source>
<year></year>
<volume>218</volume>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
