The hematoma was reabsorbed spontaneously within 4 months after the procedure b, case 1. Spontaneous subcapsular renal hematoma ssrh emerged as a complication of acute pyelonephritis apn is an extremely rare condition. Subcapsular hematoma after ureteroscopy and laser lithotripsy article pdf available in journal of endourology endourological society 279 may 20 with 472 reads how we measure reads. Chronic subcapsular hepatic hematoma radiology case. Spontaneous rupture of the spleen due to infectious mononucleosis was first reported by king 1 in 1941. The case is presented of a 25 year old patient with choledocholithiasis and cholelithiasis, who developed a subcapsular hepatic hematoma. Findings consistent with residual chronic subcapsular hematoma. This is a pdf file of an unedited manuscript that has been accepted for publication.
After 2 difficult endoscopic biliary procedures, common bile duct stones clearance was obtained. Each patient was managed by careful observation, sedation, and nasogastric decompression, with gradual resolution of the hematoma as seen on serial liver scans. Round, slightly crescentic mass peripherally in the right hepatic lobe containing subtle calcification arrows on noncontrast and showing no contrast enhancement on arterial, pv and delayed imaging all 55 hu. The subcapsular hematoma is a serious complication, with high risk of maternal and neonatal mortality, it is seen as a complication of hypertensive diseases more frequently, busides another. We describe the case of a 75year old man with a large, 8. Medical ultrasonography, june 20, volume 15, number 2.
Ultrasonic tomography offers a convenient noninvasive method for assessing suspected splenic hematoma and can also exclude the possibility in a careful examination. Subcapsular renal hematoma srh is an uncommon complication and it is rarely described after fursl. Out of 11 patients three resolved completely without intervention, six were managed with a percutaneous drainage, while. With biliary eswl imaging of the liver by sonography,68 ct9,10 and mri8 has revealed microbubbles in the liver parenchyma in 40 to 57% of treatments, a hepatic subcapsular hematoma and an. The other causes may be due to rupture of hepatocellular carcinoma, adenoma, focal nodular hyperplasia or hemangioma 25. We showed a patient aged 63 years hospitalized due to languor, febrility, abdominal pain accompanied by nausea and vomiting. Subcapsular liver hematoma as a complication of an. An obscure case of hepatic subcapsular hematoma article pdf available in case reports in gastroenterology 51. We report a rare case of a ruptured hepatic subcapsular hematoma in the course of in a patient with hellp syndrome as a complication of preeclampsia resulting. Although autopsy series have demonstrated an incidence rate of up to 15%, the lesion is clinically less distinguished 18. Computed tomography images transverse section at the l3 level and the sketches. Introduction hepatic hematoma is a rare but possible complication of ercp. 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.
A 52yearold woman with a subcapsular liver hematoma, clinical infectious diseases, volume 52, issue 9, 1 may 2011, pages. The postulated mechanism by which occurs is an accidental puncture of the guidewire into the intrahepatic biliary tree 6. The first detailed case was reported by bansal et al. The development of subcapsular hepatic hematoma after ercp is a rare complication with only 4 cases reported in the literature 1,2. A postendoscopic retrograde cholangiopancreatography. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Hepatic capsular and subcapsular pathologic conditions. As a service to our customers we are providing this early version of the. Pdf hepatic subcapsular haematoma in a premature newborn. We present a patient who developed a large subcapsular and perirenal hematoma following ureteroscopy administered to.
Atypical hemolytic uremic syndrome ahus is a rare, lifethreatening systemic in. 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. Contrastenhanced ct scan shows multiple subcapsular hemato. Full text get a printable copy pdf file of the complete article 770k, or click on a page image below to browse page by page. Symptomatic subcapsular hepatic hematoma after renal. The hematoma is usually located around the right lobe of the liver in 75% of patients.
The usual presentation is anemia, but it can also be shock. We present a case diagnosed with ruptured subcapsular liver hematoma and purtscherlike retinopathy in a patient with postpartum hellp. We present a case of a 52yearold man who developed a large subcapsular liver hematoma following a therapeutic ercp. Spontaneous subcapsular hematoma of the fetal liver. Sequential evaluation of the mass showed an evolving ultrasound appearance which reinforced our initial impression of a subcapsular hematoma of the fetal liver. The magnitude of the hematoma, presence of hemodynamic instability, and uncertainties about the diagnosis were indications for surgery in these cases. Some cases have been connected to ketorolac given during surgery and after surgery. Initial laboratory showed leukocytosis with 56% of eosinophils. Subcapsular and perirenal hematoma after ureteroscopy and.
Postercp hepatic subcapsular hematoma, from conservative. Subcapsular hepatic hematoma is a rare complication during pregnancy, but potentially lethal and usually related to severe preeclampsia or hellp syndrome. It is a catastrophic condition that can be caused by maternal, placentar or fetal factors. Descripcion del diagnostico y tratamiento del trauma hepatico, y su clasificacion.
A hepatic subcapsular hematoma in a neonate usually presents as a gradually increasing abdominal mass without symptoms of hemorrhage. Conditions analogous to an experimental model of hypertension described by page in 1939 are called page kidney. Postercp hepatic subcapsular hematoma, from conservative therapy to emergency surgery. The present report summarizes the experience at the ucla hospital with four patients who sustained subcapsular hematomas of the liver after blunt trauma. Surgical drainage of the subcapsular hematoma may be needed 4, 6, 7. Spontaneous subcapsular splenic hematoma as the only. Hematoma subcapsular por fasciolasis liver subcapsular. Most reported cases of liver hematoma often occur during pregnancy as part of severe preeclampsia and hellp syndrome. Renal subcapsular hematoma after lumbar plexus block a, case 1. Subcapsular liver hematoma after extracorporeal shock wave. An abdominal cat sean showed a subcapsular fluid collection in the liver. The spontaneous subcapsular hematoma of the liver is very rare. Relief of symptoms occurs rapidly, and clearance of the eosinophilia is obtained in. Pdf subcapsular liver hematomas and ruptures are unusual fatal.
Pagekidney hypertension caused by chronic subcapsular hematoma richard h. Large spontaneous subcapsular hematoma of the liver. If you continue browsing the site, you agree to the use of cookies on this website. A presumptive antenatal diagnosis of a subcapsular liver hematoma sch was made based on the location and ultrasound appearance similar to sch seen in pediatric and adult patients. Pdf an obscure case of hepatic subcapsular hematoma. Spitzer, md \sb\conditions analogousto an experimental model of hyper tension described by page in 1939 are called page kidney.
Of 107 reported cases of splenic rupture associated with infectious mononucleosis, only 18 are considered to be true spontaneous ruptures. Subcapsular hepatic hematoma in an otherwise uncomplicated pregnancy. A postendoscopic retrograde cholangiopancreatography subcapsular hepatic hematoma. Spontaneous subcapsular liver hematoma associated with pregnancy. Hematoma subcapsular, nonexpanding, hematoma subcapsular, nonexpanding, 10 to 50% surface area intraparenchymal nonexpanding subcapsular haematoma of the liver rarely occurs in neonates and the diagnosis is often missed or delayed. Spontaneous subcapsular renal hematoma as a complication.
Stone fragments migration into subcapsular renal hematoma. Spontaneous retroperitoneal and subcapsular liver hematoma. The patient was operated and the presence of a subcapsular hematoma was confirmed. Bai and colleagues summarized 2848 patients post fursl, srh was reported in 11 patients 0.
There are only a few reported cases in the literature. Subcapsular hepatic hematoma is excepcional, with only twenty cases described. Due to serious anemization and hemodynamic instability, arterial embolization and finally urgent surgical evacuation of the hematoma were performed. In chronic subcapsular hematoma, the most common clinical counterpart to pages model of renal parenchymal compres. Subcapsular or perirenal hematoma is an unusual complication after semirigid ureteroscopy using pneumatic lithotripsy to treat ureteral stones.
Urolithiasis is a major clinical and economic burden for the healthcare system and extracorporeal shock wave lithotrips eswl has become a reliable therapy, mostly due to its high success rate and low adverse effects 1, 2. A subcapsular hematoma appears as a lowattenuation, elliptic collection of blood between the liver capsule and the liver parenchyma at ct caused by the compression of the underlying liver margin by the thick, fibrous glisson capsule, fig 1. A subcapsular hematoma of the liver is an accumulation of blood between glissons capsule and the liver parenchyma. Pdf spontaneous liver hematoma and a hepatic rupture in. Subcapsular haematoma of the liver rarely occurs in neonates and the diagnosis is often missed or delayed. Liver hematoma is the most common intraabdominal injury secondary to birth trauma fig. Renal subcapsular hematoma after lumbar plexus block.
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