Certain areas of the globe are considered highly endemic, including central and south america, asia, western europe, africa, and the middle east. Early recognition and prompt management are essential for preventing catastrophic consequences including ischemic liver failure and hypovolemic shock. Subcapsular liver hematoma as a complication of an. Intrahepatic subcapsular haematoma ish is a rare and potentially lifethreatening complication of lc. Post ercp hepatic subcapsular hematoma, from conservative therapy to emergency surgery. Herein, we reported a rare giant ish after lc and summarized all of the reported cases. The development of subcapsular hepatic hematoma after ercp is a rare complication with only 4 cases reported in the literature 1,2. Treatment of subcapsular haematoma, a complication of extracorporeal shock wave lithotripsy eswl, by percutaneous drainage. Hematoma subcapsular intraparenquimatoso hepatico roto, una. Post ercp bleeding complications are rare and mainly post sphincterotomy.
Subcapsular lesion of the liver gastroenterology medhelp. Rare unexpected post ercp complication such as subcapsular hepatic hematoma was firstly described in 2000 4. A neonate was delivered by vaginal delivery after 29 weeks and three days gestation with breech presentation. Rare unexpected post ercp complication such as subcapsular hepatic hematoma was firstly described in 2000. Post eswl perinephric haematoma is a rare complication, with an incidence rate of 0. Subcapsular hematoma of the liver after laparoscopic. Request pdf subcapsular hepatic hematoma post ercp. Hi all, i just got a report from my endocrinologist after trying to find a few answers to some ongoing health concerns that seemed hormonal but it looks like they might not be after all. Over the last two decades, a reduction in postoperative morbidity, mortality and hospital stay have seen a complete shift from open surgery to a laparoscopic approach. Hematoma subcapsular intraparenquimatoso hepatico roto. Here we report a case of a 32yearold primiparous female at 36 weeks of gestation, admitted to a maternity ward of a private clinic for preeclampsia. We report a 54yearold lady presenting high fever, dysuria followed 5 days later by acute onset left flank pain and uncontrolled hypertension. Hepatic capsular and subcapsular pathologic conditions. An incidentally detected hepatic subcapsular hematoma in a.
The appearance of subcapsular liver hematoma after a laparoscopic cholecystectomy lc is an infrequent complication and seldom studied. Hepatic hematoma is a rare but possible complication of ercp. Spontaneous retroperitoneal and subcapsular liver hematoma. We report an unusual case of left hepatic lobe subcapsular hematoma after ercp presenting with a drop in hemoglobin, tachycardia and intraabdominal collection.
This is a pdf file of an unedited manuscript that has been accepted for publication. Pdf subcapsular liver hematoma after ercp 4 researchgate. Case report guido contreras tamayo, francisco javier buenrostro perez. Spontaneous subcapsular renal hematoma is an uncommon entity. Nowadays endoscopic retrograde cholangiopancreatography ercp is a minimally invasive technique with a complication rate around 2. Intrahepatic subcapsular hematoma ish is an extremely rare, lifethreatening complication after laparoscopic cholecystectomy lc. In this lesson, we will learn more about hepatic hematomas and how to treat them. Fascioliasis is a foodborne transmitted zoonosis caused by the liver trematode f. Subcapsular hepatic hematoma following endoscopic retrograde cholangiopancreatography. It is a catastrophic condition that can be caused by maternal, placentar or fetal factors. A subcapsular hematoma of the liver is an accumulation of blood between glissons capsule and the liver parenchyma. Urinary infection and spontaneous subcapsular renal hematoma. A rare intrahepatic subcapsular hematoma ish after. Cerwenka h, werkgartner g, bacher h, elshabrawi a, mi.
A hepatic subcapsular hematoma in a neonate shows a nonspecific presentation such as the presence of an abdominal mass without symptoms of hemorrhage and is clinically less distinguished as compared to cases detected during an autopsy. Subcapsular hepatic hematoma after ercp request pdf. Hellp syndrome complicated by subcapsular hematoma of. After close monitoring for two days at the intensive. Additional bleeding complications result from lesions of the spleen or the duodenal wall or colon caused by unusual movements of the endoscope with traction on the abdominal vessels 416. Atypical hemolytic uremic syndrome ahus is a rare, lifethreatening systemic in. However there have been some complications peculiar to lc. Some cases have been connected to ketorolac given during surgery and after surgery. Introduction hepatic hematoma is a rare but possible complication of ercp. A rare complication is the occurrence of subcapsular. Subcapsular hematoma of the liver due to intercostal. We present the case of a 52yearold woman with a history of recurring upper abdominal pain and a clinical and ultrasonographic diagnosis of obstructive jaundice due to common bile duct stones. Hepatic compartment syndrome is an increase in intrahepatic pressure sufficient to cause compromised hepatic perfusion. Two rare cases of intrahepatic subcapsular hematoma after.
Selective angiography identified the presence of pseudoaneurysm in the right hepatic artery. In selected patients with subcapsular hematoma of the liver, nonoperative management may be desirable. Case a 54yearold man with a past history of decompensated cirrhosis secondary to hepatitis c and alcohol abuse. Preoperative imaging showed that all four patients had obstructing proximal ureteral stones ranging in size from 0. The occurrence of pseudoaneurysm is considered a risk factor. We describe the case of a 75year old man with a large, 8. Renal subcapsular hematoma after lumbar plexus block. The hematoma was reabsorbed spontaneously within 4 months after the procedure b, case 1. A rare case of subcapsular liver haematoma following laparoscopic cholecystectomy victoria brown,1 jennifer martin,2 damian magee1 1department of general. Intraparenchymal and subcapsular hepatic hematoma was reported following ercp as. Subcapsular hepatic hematoma is a rare and little reported complication post ercp resulting in significant morbidity. The diagnostic contribution of ct, us and ceus the change of the therapeutic management in abdominal hemorrhages, from an invasive approach towards a non. Renal subcapsular hematoma after lumbar plexus block a, case 1.
Although it is rare and potentially lifethreatening condition after ercp. The liver capsule is not visible at ct or mr imaging under normal conditions. Hepatic subcapsular haematoma in a premature newborn bmj. Resolucion del caso del hematoma hepatico tras cirugia casos. Ultrasound, computed tomography and magnetic resonance imaging showed a subcapsular hematoma in the left kidney. Hepatic subcapsular hematoma and neonatal hemophilia.
Because she was apyrexial and hemodynamically stable, she was conservatively managed with a broadspectrum antibiotic and gradually recovered. A wide spectrum of infectious and inflammatory diseases can affect the hepatic capsular and subcapsular regions by way of peritoneal, hematogenous, biliary, and perihepatic ligamentous routes. A 78yearold woman was admitted with acute cholecystitis due to cholecystolithiasis. Subcapsular liver hematoma after endoscopic retrograde. Endoscopic retrograde cholangiopancreatography ercp, subcapsular hepatic hematoma, liver transplantation, bile leak, biliary complications. A postendoscopic retrograde cholangiopancreatography. The management of ish is dependent on the patients clinical status and the size of the haematoma. Pdf subcapsular liver haematoma as a complication of. Subcapsular hematoma of the liver due to intercostal anesthesic blockage after cholecystectomy. The time interval to diagnose ish after lc ranged from seven hours to six weeks. In a newborn with hypovolemic shock and abdominal distension.
Rupture of subcapsular hematoma of liver in severe. If your liver is injured, it can result in a hepatic hematoma. In a case described in the literature, subcapsular haematoma developed a week after removal of the gallbladder. After 2 difficult endoscopic biliary procedures, common bile duct stones clearance was obtained. Nsaids to control the post operative pain, and most of them used ketorolac, however, 35. Interventional management of subcapsular hepatic hematoma. The postulated mechanism by which occurs is an accidental puncture of the guidewire into the intrahepatic biliary tree 6. In this case, the patient was considered to be clinically unstable, showing signs.
A rare complication of intraabdominal hematoma after ercp. Subcapsular hepatic abscess post laparoscopic cholecystectomy. Subcapsular hepatic hematoma is an extremely rare complication of ercp, but the occurrence of abdominal pain after ercp should raise the suspicion of this complication. Pdf intrahepatic subcapsular hematoma suhail f khuroo. A high index of suspicion is essential for early identification and stabilisation of babies with such a pathology.
This is the rare case of laparoscopic adrenalectomy resulting in. A subcapsular right liver lobe haematoma and a large peritoneal effusion were identified. Post ursl subcapsular hematoma was diagnosed in 4 of 1114 0. This report describes the case of a patient who developed a subcapsular hepatic hematoma 48hours after endoscopic retrograde cholangiopancreatography. Computed tomography images transverse section at the l3 level and the sketches. Subcapsular liver hematoma slh is a rare complication of severe preeclampsia and hellp syndrome. A 55 yearsold woman cholecystectomy years before was admitted to our hospital with right upper abdominal. Postpartum spontaneous subcapsular hepatic hematoma.
Hematoma subcapsular intraparenquimatoso hepatico roto, una rara complicacion post colangiopancreatografia retrograda endoscopica. These patients must be followed up in intensive care unit for advanced medical support with infused fluid, replacement of blood products, and treatment of underlying disorders. Subcapsular hematoma of the liver represents an unusual clinical phenomenon in the pregnancy and postpartum period with serious complications in terms of fetal and maternal mortality. Laparoscopic treatment of a hepatic subcapsular abscess. I had a ct thorax to rule out the recurrence of a benign thymic tumor that i had removed years ago, and. An unusual, but potentially lifethreating post ercp complication. A 55 yearsold woman cholecystectomy years before was admitted to our hospital with right upper abdominal discomfort. Laparoscopic cholecystectomy lc is a safe and less traumatic procedure for benign cholecystic disease. A case with subcapsular hematoma of the liver following.
Subcapsular hepatic hematoma after endoscopic retrograde. Subcapsular haematoma of the liver rarely occurs in neonates and the diagnosis is often missed or delayed. Subcapsular liver hematoma hepatic subcapsular hematoma. Each patient was managed by careful observation, sedation, and nasogastric decompression, with gradual resolution of the hematoma as seen on serial liver scans. We report a case of rare post ercp complication, subcapsular liver hematoma that was diagnosed 16 hour post ercp in 28yearold lady with intraabdominal collection, ultrasound guided drainage of. A 34yearold female underwent lc for uncomplicated cholelithiasis.
The subcapsular hematoma is a serious complication. Pdf on feb 1, 2007, p priego and others published subcapsular liver hematoma after ercp. There are a lot of therapeutic options varying from conservative management to surgical. Case report a rare case of subcapsular liver haematoma. It therefore makes it imperative for these patients to be followed up in intensive care unit for advanced medical support with fluid and electrolyte management, replacement of blood products, and treatment of underlying disorders. Muestra imagen tubular con abundantes grumos en su interior y material ecogeno en su interior, con refuerzo ecogenico posterior. Subcapsular hematoma after ureteroscopy and laser lithotripsy. We report an unusual case of left hepatic lobe subcapsular hematoma after ercp.
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