Subcapsular perirenal hematoma radiology reference. The case is presented of a 25 year old patient with choledocholithiasis and cholelithiasis, who developed a subcapsular hepatic hematoma. Initial laboratory showed leukocytosis with 56% of eosinophils. The hematoma is usually located around the right lobe of the liver in 75% of patients. Laparoscopic evacuation of a subcapsular renal hematoma causing symptomatic hypertension. Endoscopic retrograde cholangiopancreatography is a very common therapeutic procedure for a variety of biliary and pancreatic duct diseases.
Hellp syndrome complicated by subcapsular hematoma of. To determine the clinical characteristics and management of subcapsular hepatic hematoma shh as a result of severe preeclampsia and hellp syndrome in the period 20042016. Hematoma subcapsular hepatico roto en sindrome hellp. With subcapsular hematoma, the patients symptoms will vary depending on the degree and duration of the bleed. The complications can be devastating in terms of fetal and maternal mortality. Sequential evaluation of the mass showed an evolving ultrasound appearance which reinforced our initial impression of a subcapsular hematoma of the fetal liver. Hematoma hepatico subcapsular roto en sindrome hellp. Subcapsular hepatic hematoma secondary to endoscopic retrograde cholangiopancreatography is a rare complication, but is potentially lifethreating. We report a 54yearold lady presenting high fever, dysuria followed 5 days later by acute onset left flank pain and uncontrolled hypertension. Conversely, a hepatic hematoma is an injury in which there was bleeding, but it has essentially clotted. A high index of suspicion is essential for early identification and stabilisation of babies with such a pathology. It is a catastrophic condition that can be caused by maternal, placentar or fetal factors. Postpartum spontaneous subcapsular hepatic hematoma sshh. Hepatic capsular and subcapsular pathologic conditions.
Subcapsular hepatic hematoma after ercp endoscopic retrograde. 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 liver hematoma hepatic subcapsular hematoma. Subcapsular haematoma of the liver rarely occurs in neonates and the diagnosis is often missed or delayed.
In addition, there is a lucency traversing the lower pole of the kidney that represents a renal laceration. Surgical drainage of the subcapsular hematoma may be needed 4, 6, 7. Percutaneous renal biopsy results in subcapsular hematoma in approximately 28% and in some degree of perirenal hemorrhage in over 90% of patients. Humberto rosas l 1, carlos fiestas f 2, richard torres m 2, giorgio aita c 2, david lozada m 2. Hematoma subcapsular por fasciolasis liver subcapsular. Spontaneous subcapsular liver hematoma associated with pregnancy. Readable by all users, writable by nucmed certifiers keywords. 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. Subcapsular liver hematoma slh is a rare complication of severe preeclampsia and hellp syndrome. Procedure related complications are more frequent than in other endoscopic procedures. Distinction between perirenal and subcapsular collections. 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. Ruptured subcapsular liver hematoma during pregnancy.
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. Spontaneous subcapsular hematoma of the fetal liver. The most common reported complications are pancreatitis, bleeding, perforation, and infection. There isnt active bleeding, and the blood is collected in a sealed area. 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. These outcomes are often fulminant evolution, and maternal mortality amounted to more than 50%.
Descriptive, retrospective study, series of cases type. We report a case of subcapsular hematoma of the liver without any apparent lesion and in the absence of coagulopathy. There is a subcapsular fluid collection that compresses the adjacent renal parenchyma red arrow. Urinary infection and spontaneous subcapsular renal hematoma. 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 serious diseases such as acute fatty liver of pregnancy, trauma, infectious diseases. Relief of symptoms occurs rapidly, and clearance of the eosinophilia is obtained in. 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. Based on limited reports the clinical presentations of patients with a singular kidney and renal allografts include flank paintenderness, acute renal failure and decreased urine output. Summary hellp syndrome is a rare condition related to pregnancy. Learning radiology subcapsular, hematoma, renal, laceration. A subcapsular hematoma of the liver is an accumulation of blood between glissons capsule and the liver parenchyma.
Pdf an obscure case of hepatic subcapsular hematoma. Subcapsular hepatic hematoma in an otherwise uncomplicated pregnancy. Spontaneous subcapsular renal hematoma is an uncommon entity. A 41yearold male, paraplegic for 16 years, presented to the emergency department 3 days after sudden onset of right upper quadrant and shoulder pain. Very few of these hematomas, however, are clinically significant. The woman underwent an emergency caesarean section with the. The magnitude of the hematoma, presence of hemodynamic instability, and uncertainties about the diagnosis were indications for surgery in these cases. Spontaneous subcapsular hematoma of the liver, with no history of preeclampsia and hellp syndrome hemolysis, elevated liver enzymes, and low platelet count. 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.
Case report a 36yearold c aucasian primigravida at 34 weeks of gestation was admitted at our emergency depart ment complaining of nausea, vomiting, mala ise and epigastric, right upper quadrant tand shoulder pain. An obscure case of hepatic subcapsular hematoma article pdf available in case reports in gastroenterology 51. The patient was operated and the presence of a subcapsular hematoma was confirmed. Chronic subcapsular hepatic hematoma radiology case. Ultrasound, computed tomography and magnetic resonance imaging showed a subcapsular hematoma in the left kidney. Subcapsular hematoma and laceration of left kidney. There are a lot of therapeutic options varying from conservative management to surgical treatment including hepatic. Subcapsular definition of subcapsular by the free dictionary. 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. In most cases, this is managed surgically, but the mortality rate is high, up to 50% of all patients. Findings consistent with residual chronic subcapsular hematoma. Subcapsular hepatic hematoma secondary to endoscopic retrograde.
646 1475 1184 920 1367 1234 65 1313 453 1409 1460 1350 1425 125 1326 864 991 227 67 1096 618 1130 990 705 826 1159 878 296 81 207 620 993