<?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>2011-7582</journal-id>
<journal-title><![CDATA[Revista Colombiana de Cirugía]]></journal-title>
<abbrev-journal-title><![CDATA[rev. colomb. cir.]]></abbrev-journal-title>
<issn>2011-7582</issn>
<publisher>
<publisher-name><![CDATA[Asociación Colombiana de Cirugía]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2011-75822021000300549</article-id>
<article-id pub-id-type="doi">10.30944/20117582.664</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Manejo de la ruptura hepática espontánea en el síndrome de HELLP]]></article-title>
<article-title xml:lang="en"><![CDATA[Management of spontaneous hepatic rupture in HELLP syndrome]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pacheco-Molina]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vergara-Miranda]]></surname>
<given-names><![CDATA[Héctor]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Álvarez-Lozada]]></surname>
<given-names><![CDATA[Luis Adrián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vásquez-Fernández]]></surname>
<given-names><![CDATA[Francisco]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Autónoma de Nuevo León  ]]></institution>
<addr-line><![CDATA[Monterrey ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Autónoma de Nuevo León  ]]></institution>
<addr-line><![CDATA[Monterrey ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2021</year>
</pub-date>
<volume>36</volume>
<numero>3</numero>
<fpage>549</fpage>
<lpage>553</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S2011-75822021000300549&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S2011-75822021000300549&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S2011-75822021000300549&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción.  El síndrome de HELLP es una variante grave de la preeclampsia, con una baja incidencia, entre el 0,5-0,9 % de todos los embarazos. La ruptura hepática espontánea en el embarazo es infrecuente, presenta una alta mortalidad, y se ha relacionado con hemangiomas hepáticos, coriocarcinoma y síndrome de HELLP.  Caso clínico.  Mujer de 29 años con embarazo de 34,3 semanas, con actividad uterina progresiva, sufrimiento fetal agudo y hallazgos compatibles con síndrome de HELLP. Se practicó cesárea de urgencia encontrando hemoperitoneo y ruptura hepática del lóbulo derecho, por lo que se realizó empaquetamiento abdominal y posterior reintervención quirúrgica.  Discusión.  La ruptura hepática espontánea en el embarazo es una entidad infrecuente y potencialmente mortal. Es esencial un alto nivel de sospecha para realizar el diagnóstico y la rápida intervención. Requiere un manejo multidisciplinario para un resultado exitoso. Se han descrito múltiples tratamientos que dependen de las manifestaciones clínicas y extensión de la lesión, pero es claro que la laparotomía primaria y el taponamiento constituyen la mejor elección ante el hallazgo intraoperatorio.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction.  HELLP syndrome is a severe variant of preeclampsia with a low incidence, between 0.5-0.9% of all pregnancies. Spontaneous hepatic rupture in pregnancy is rare, has a high mortality, and has been associated with hepatic hemangiomas, choriocarcinoma, and HELLP syndrome.  Clinical case.  29-year-old woman with a 34.3-week pregnancy, with progressive uterine activity and acute fetal distress and findings compatible with HELLP syndrome. An emergency cesarean section was performed, finding hemoperitoneum and hepatic rupture of the right lobe, performing abdominal packing and subsequent surgical reoperation.  Discussion.  Spontaneous liver rupture in pregnancy is a rare and potentially fatal entity. A high level of suspicion is essential to make the diagnosis and prompt intervention. It requires multidisciplinary management for a successful outcome. Multiple treatments have been described that depend on the clinical manifestations and extent of the lesion, but it is clear that primary laparotomy and packing constitute the best choice before the intraoperative finding.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[síndrome de HELLP]]></kwd>
<kwd lng="es"><![CDATA[rotura espontánea]]></kwd>
<kwd lng="es"><![CDATA[hígado]]></kwd>
<kwd lng="es"><![CDATA[complicaciones del embarazo]]></kwd>
<kwd lng="es"><![CDATA[cirugía]]></kwd>
<kwd lng="es"><![CDATA[reintervención]]></kwd>
<kwd lng="es"><![CDATA[control de daños]]></kwd>
<kwd lng="en"><![CDATA[HELLP syndrome]]></kwd>
<kwd lng="en"><![CDATA[rupture, spontaneous]]></kwd>
<kwd lng="en"><![CDATA[liver pregnancy complications]]></kwd>
<kwd lng="en"><![CDATA[surgery reoperation]]></kwd>
<kwd lng="en"><![CDATA[damage control]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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