<?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>2524-177X</journal-id>
<journal-title><![CDATA[Revista médica del Hospital General de México]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. med. Hosp. Gen. Méx.]]></abbrev-journal-title>
<issn>2524-177X</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Médica del Hospital General de México A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2524-177X2023000200085</article-id>
<article-id pub-id-type="doi">10.24875/hgmx.22000056</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Report of a case of liver rupture in preeclampsia and HELLP syndrome]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Herrera-Salgado]]></surname>
<given-names><![CDATA[Jésser M.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López-Parra]]></surname>
<given-names><![CDATA[María V.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Malagón-Reyes]]></surname>
<given-names><![CDATA[Ricardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Reyes]]></surname>
<given-names><![CDATA[Luis E.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ángeles-Vázquez]]></surname>
<given-names><![CDATA[María de J.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castorena-de Avila]]></surname>
<given-names><![CDATA[Rubén]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Eláceo-Fernández]]></surname>
<given-names><![CDATA[Itzel C.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Briones-Garduño]]></surname>
<given-names><![CDATA[Jesús C.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mendieta-Zerón]]></surname>
<given-names><![CDATA[Hugo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Materno Perinatal Mónica Pretelini Obstetric Intensive Care Unit ]]></institution>
<addr-line><![CDATA[Toluca State of Mexico]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2023</year>
</pub-date>
<volume>86</volume>
<numero>2</numero>
<fpage>85</fpage>
<lpage>90</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2524-177X2023000200085&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2524-177X2023000200085&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2524-177X2023000200085&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Liver rupture secondary to preeclampsia represents a complication that, if is not recognized early, can be fatal. Its presentation is rare, but very complex to treat, having options that are not clearly protocolized and usually derive from the experience of the surgeon who faces it. We present a case of liver rupture of a patient from Toluca, State of Mexico who was admitted by emergency air transfer with immediate puerperium complicated by severe preeclampsia, postpartum hemorrhage, liver rupture with hemodynamic instability, it was necessary to intervene surgically for a total of seven occasions to control the hemorrhage, as well as pharmacological, medical measures and multiple transfusions; however, she died on the eighteenth day of his hospitalization for septic shock.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Preeclampsia]]></kwd>
<kwd lng="en"><![CDATA[HELLP syndrome]]></kwd>
<kwd lng="en"><![CDATA[Liver rupture]]></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[Agarwal]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Joy]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Das]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Dash]]></surname>
<given-names><![CDATA[NR]]></given-names>
</name>
<name>
<surname><![CDATA[Srivastava]]></surname>
<given-names><![CDATA[DN]]></given-names>
</name>
<name>
<surname><![CDATA[Madhusudhan]]></surname>
<given-names><![CDATA[KS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hemorrhage and rupture of an unusual benign liver lesion in pregnancy:a case report]]></article-title>
<source><![CDATA[J Clin Exp Hepatol]]></source>
<year>2021</year>
<volume>11</volume>
<page-range>260-3</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[Perez-Medina]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Spontaneous Rupture of Liver during Pregnancy]]></article-title>
<source><![CDATA[Mahadahonda]]></source>
<year>2016</year>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</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>
<page-range>106-12</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[Kanonge]]></surname>
<given-names><![CDATA[TI]]></given-names>
</name>
<name>
<surname><![CDATA[Chamunyonga]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Zakazaka]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Chidakwa]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Madziyire]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hepatic rupture from haematomas in patients with pre-eclampsia/eclampsia:a case series]]></article-title>
<source><![CDATA[Pan Afr Med J]]></source>
<year>2018</year>
<volume>31</volume>
<page-range>86</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[Frise]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
<name>
<surname><![CDATA[Davis]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Barker]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Wilkinson]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Mackillop]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hepatic capsular rupture in pregnancy]]></article-title>
<source><![CDATA[Obstet Med]]></source>
<year>2016</year>
<volume>9</volume>
<page-range>185-8</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[Golan]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[White]]></surname>
<given-names><![CDATA[RG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Spontaneous rupture of the liver associated with pregnancy A report of 5 cases]]></article-title>
<source><![CDATA[S Afr Med J]]></source>
<year>1979</year>
<volume>56</volume>
<page-range>133-6</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Briones]]></surname>
<given-names><![CDATA[GJ]]></given-names>
</name>
<name>
<surname><![CDATA[Guerrero]]></surname>
<given-names><![CDATA[HA]]></given-names>
</name>
<name>
<surname><![CDATA[de León Ponce]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
<name>
<surname><![CDATA[Mendoza]]></surname>
<given-names><![CDATA[LE]]></given-names>
</name>
<name>
<surname><![CDATA[Vega]]></surname>
<given-names><![CDATA[CG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ruptura hepática en preeclampsia]]></article-title>
<source><![CDATA[Rev Asoc Mex Med Crit Y Ter Int]]></source>
<year>2012</year>
<volume>26</volume>
<page-range>99-100</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[Yacob]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Jesudason]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Nayak]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Spontaneous liver rupture:A report of two cases]]></article-title>
<source><![CDATA[J Emerg Trauma Shock]]></source>
<year>2013</year>
<volume>6</volume>
<page-range>50-2</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[Higareda]]></surname>
<given-names><![CDATA[SH]]></given-names>
</name>
<name>
<surname><![CDATA[Ruvalcaba Ramírez]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Navarro]]></surname>
<given-names><![CDATA[IM]]></given-names>
</name>
<name>
<surname><![CDATA[Cruz]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
<name>
<surname><![CDATA[Ávila]]></surname>
<given-names><![CDATA[CE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ruptura hepática asociada con síndrome HELLP:una urgencia quirúrgica Hepatic rupture associated with HELLP syndrome:a surgical emergency]]></article-title>
<source><![CDATA[Cir Gen]]></source>
<year>2016</year>
<volume>38</volume>
<page-range>20-1</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[You]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Chung]]></surname>
<given-names><![CDATA[YE]]></given-names>
</name>
<name>
<surname><![CDATA[Chung]]></surname>
<given-names><![CDATA[HS]]></given-names>
</name>
<name>
<surname><![CDATA[Joo]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Chung]]></surname>
<given-names><![CDATA[SP]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[HS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Spontaneous hepatic rupture caused by hemolysis, elevated liver enzymes, and low platelet count syndrome]]></article-title>
<source><![CDATA[Am J Emerg Med]]></source>
<year>2014</year>
<volume>321</volume>
<page-range>686-e3-4</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[Vidarte]]></surname>
<given-names><![CDATA[MF]]></given-names>
</name>
<name>
<surname><![CDATA[Montes]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Loaiza-Osorio]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Calvache]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hepatic rupture associated with preeclampsia, report of three cases and literature review]]></article-title>
<source><![CDATA[J Matern Fetal Neonatal Med]]></source>
<year>2019</year>
<volume>32</volume>
<page-range>2767-73</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[Troja]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Abdou]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Rapp]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Wienand]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Malik]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Raab]]></surname>
<given-names><![CDATA[HR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Management of spontaneous hepatic rupture on top of HELLP syndrome:case report and review of the literature]]></article-title>
<source><![CDATA[Viszeralmedizin]]></source>
<year>2015</year>
<volume>31</volume>
<page-range>205-8</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[Reyes]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
<name>
<surname><![CDATA[Mendoza]]></surname>
<given-names><![CDATA[LE]]></given-names>
</name>
<name>
<surname><![CDATA[Vásquez]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
<name>
<surname><![CDATA[Zerón]]></surname>
<given-names><![CDATA[HM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Experience of the MALA bag in the open abdomen management in an obstetrical intensive care unit]]></article-title>
<source><![CDATA[Acta Med Port]]></source>
<year>2013</year>
<volume>26</volume>
<page-range>699-704</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[Millan]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Forero]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Right hepatectomy after spontaneous hepatic rupture in a patient with preeclampsia:a case report]]></article-title>
<source><![CDATA[Int J Surg Case Rep]]></source>
<year>2017</year>
<volume>39</volume>
<page-range>250-2</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Araujo]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
<name>
<surname><![CDATA[Leao]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
<name>
<surname><![CDATA[Nobrega]]></surname>
<given-names><![CDATA[MH]]></given-names>
</name>
<name>
<surname><![CDATA[Bezerra]]></surname>
<given-names><![CDATA[PF]]></given-names>
</name>
<name>
<surname><![CDATA[Pereira]]></surname>
<given-names><![CDATA[FV]]></given-names>
</name>
<name>
<surname><![CDATA[Dantas]]></surname>
<given-names><![CDATA[EM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Characteristics and treatment of hepatic rupture caused by HELLP syndrome]]></article-title>
<source><![CDATA[Am J Obstet Gynecol]]></source>
<year>2006</year>
<volume>195</volume>
<page-range>129-33</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gyang]]></surname>
<given-names><![CDATA[AN]]></given-names>
</name>
<name>
<surname><![CDATA[Srivastava]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Asaad]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Liver capsule rupture in eclampsia:treatment with hepatic artery embolisation]]></article-title>
<source><![CDATA[Arch Gynecol Obstet]]></source>
<year>2006</year>
<volume>274</volume>
<page-range>377-9</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Shames]]></surname>
<given-names><![CDATA[BD]]></given-names>
</name>
<name>
<surname><![CDATA[Fernandez]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
<name>
<surname><![CDATA[Sollinger]]></surname>
<given-names><![CDATA[HW]]></given-names>
</name>
<name>
<surname><![CDATA[Chin]]></surname>
<given-names><![CDATA[LT]]></given-names>
</name>
<name>
<surname><![CDATA[D'Alessandro]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Knechtle]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Liver transplantation for HELLP syndrome]]></article-title>
<source><![CDATA[Liver Transpl]]></source>
<year>2005</year>
<volume>11</volume>
<page-range>224-8</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sutton]]></surname>
<given-names><![CDATA[BC]]></given-names>
</name>
<name>
<surname><![CDATA[Dunn]]></surname>
<given-names><![CDATA[ST]]></given-names>
</name>
<name>
<surname><![CDATA[Landrum]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Mielke]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fatal postpartum spontaneous liver rupture:case report and literature review]]></article-title>
<source><![CDATA[J Forensic Sci]]></source>
<year>2008</year>
<volume>53</volume>
<page-range>472-5</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nelson]]></surname>
<given-names><![CDATA[DB]]></given-names>
</name>
<name>
<surname><![CDATA[Dearmon]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Nelson]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Spontaneous rupture of the liver during pregnancy:a case report]]></article-title>
<source><![CDATA[J Obstet Gynecol Neonatal Nurs]]></source>
<year>1989</year>
<volume>18</volume>
<page-range>106-13</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dubey]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Rani]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hepatic rupture in preeclampsia and HELLP syndrome:a catastrophic presentation]]></article-title>
<source><![CDATA[Taiwan J Obstet Gynecol]]></source>
<year>2020</year>
<volume>59</volume>
<page-range>643-51</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
