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