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Subcapsular Liver Hematoma

Hepatic Subcapsular Hematoma


Presentation

  • Mycotic aneurysm or pseudoaneurysm of visceral vessels may develop from bacteremia and its dissection or rupture should be suspected in patients presenting with sepsis and abdominal pain.[ncbi.nlm.nih.gov]
  • Abstract This case report describes a 27-week, 1040-g infant, whose mother presented with an acute abruption and fetal distress prompting emergency cesarean birth.[ncbi.nlm.nih.gov]
  • OBJECTIVES: To discuss the presentation, evaluation, and management options of hepatic subcapsular hematoma.[ncbi.nlm.nih.gov]
  • In physical examination epigastric tenderness was present. Patient went under ERCP procedure due to choledocholithiasis. 1.5 cm of filling defect was seen in hilar region in ERCP.[scopemed.org]
  • Subcapsular hematomas of the liver in neonates uncommonly present as an abdominal mass without clinical signs of bleeding.[ncbi.nlm.nih.gov]
Fever
  • General Discussion: FULL PATIENT HISTORY: 22-year-old woman with fever, shortness of breath, abdominal pain and abnormal liver function tests 2 weeks after laparoscopic cholecystectomy.[gamma.wustl.edu]
  • Patient was admitted presenting fever and abdominal pain postoperative month 1. USG and CT revealed that an approximately 10x3 cm heterogenic collection adjacent to the left lobe of the liver was reaching out to epigastrium.[scopemed.org]
  • Different symptoms are described in literature abdominal pain (91%), hypotension (39.1%), anemia (39.1%), fever (21.7%) and peritonism (13%) [8] .[ijhpd.com]
  • The most common manifestation was abdominal pain in 87%; in some case reports fever was mentioned to be one of the primary manifestations, but we found that right omalgia and clinical manifestations of hypovolemic shock (tachycardia or hypotension) were[elsevier.es]
Nightmare
  • Rupture of Subcapsular Hematoma of Liver in Severe Preeclampsia with HELLP syndrome: A Nightmare to an Obstetrician Corresponding Author: Dr.[casereports.in]
Abdominal Pain
  • Mycotic aneurysm or pseudoaneurysm of visceral vessels may develop from bacteremia and its dissection or rupture should be suspected in patients presenting with sepsis and abdominal pain.[ncbi.nlm.nih.gov]
  • A sixty-nine-year-old female patient was admitted to the clinic with abdominal pain and jaundice. In physical examination epigastric tenderness was present.[scopemed.org]
  • CONCLUSION: In a patient with undifferentiated right upper quadrant abdominal pain, bedside ultrasonography is a rapid and effective modality in the diagnosis of liver masses, including subcapsular hematoma. Copyright 2013 Elsevier Inc.[ncbi.nlm.nih.gov]
  • General Discussion: FULL PATIENT HISTORY: 22-year-old woman with fever, shortness of breath, abdominal pain and abnormal liver function tests 2 weeks after laparoscopic cholecystectomy.[gamma.wustl.edu]
  • Abdominal pain associated with hypotension and tachycardia after ERCP should raise the suspicion of intrahepatic bleeding with capsule distension.[ijhpd.com]
Hepatomegaly
  • Congenital malformation of liver NOS nodular, focal K76.89 Hypertrophy, hypertrophic liver R16.0 ICD-10-CM Diagnosis Code R16.0 Hepatomegaly, not elsewhere classified 2016 2017 2018 2019 Billable/Specific Code Applicable To Hepatomegaly NOS acute K76.89[icd10data.com]
  • ALP isoenzyme test (Medical Encyclopedia) Ascites (Medical Encyclopedia) Diet - liver disease (Medical Encyclopedia) Hepatic encephalopathy (Medical Encyclopedia) Hepatomegaly (Medical Encyclopedia) Liver disease (Medical Encyclopedia) Liver scan (Medical[icdlist.com]
  • On examination, she was found to have mild pallor, and a tender hepatomegaly. There was no icterus and the patient was hemodynamically stable, her blood pressure was also normal.[panafrican-med-journal.com]
Shoulder Pain
  • However, shoulder pain should also be regarded with suspicion in patients with preeclampsia.[ncbi.nlm.nih.gov]
  • However, shoulder pain should also be regarded with suspicion in patients with preeclampsia. (J Reprod Med 1996;41:125-128)[reproductivemedicine.com]
  • The SLH may present as right upper quadrant abdominal pain or shoulder pain, abdominal distension, nausea or vomiting.[casereports.in]
Vaginal Bleeding
  • The third patient experienced uncontrollable vaginal bleeding, liver hemorrhage, and was in imminent danger of capsule rupture.[ncbi.nlm.nih.gov]

Workup

Pericardial Effusion
  • Sudden onset breathlessness on day 6 secondary to pleural and pericardial effusion was managed conservatively [Fig.3]. Over the time, drain output reduced and drain was removed by 20 and 25 day respectively.[casereports.in]

Treatment

  • The most common indications for ERCP include treatment of bile leaks and anastomotic and nonanastomotic biliary strictures.[ncbi.nlm.nih.gov]
  • CONCLUSION: Recombinant factor VIIa is an effective adjunct in the treatment of preeclamptic patients with expanding or ruptured subcapsular liver hematoma.[ncbi.nlm.nih.gov]
  • Conservative treatment was successful in three patients. Emergency surgical intervention was necessary in two patients, including one liver transplantation.[ncbi.nlm.nih.gov]
  • A review of the known and proposed risk factors, clinical signs and symptoms, pathophysiology, and treatment of both SBP and SLH are provided.[ncbi.nlm.nih.gov]
  • Comprehensive discussions of clinical disorders review the surgical treatment options.[books.google.com]

Prognosis

  • The prognosis is usually marked by the death of the patient, as in our case.[ncbi.nlm.nih.gov]
  • , Queen Elizabeth Hospital, Bridgetown, Barbados. [email protected] Abstract HELLP (hemolysis, elevated liver enzymes and low platelets) syndrome is an obstetric complication with heterogeneous presentation, multisystem involvement and variable prognosis[ncbi.nlm.nih.gov]
  • […] unenhanced aberrant portal or hepatic veins congenital fissures and clefts: typically fat density, and in usualy locations diaphragmatic slips or eventration : identifiable on coronal images pre-existing liver lesions cysts hemangioma Treatment and prognosis[radiopaedia.org]
  • Multicenter prospective clinical study to evaluate the prediction of short-term outcome in pregnant women with suspected preeclampsia (PROGNOSIS): study protocol. BMC Pregnancy Childbirth. 2014 Sep 18; 14: 324 22.[cobas.roche.it]
  • Though looking alarming, awareness of this entity and visualization with computed tomography can help to explain the prognosis to the patients Competing interests The authors declare no competing interests.[panafrican-med-journal.com]

Etiology

  • We describe the pertinent radiologic features of the subcapsular hematomas in these patients, and discuss possible etiologies for the bleeding in each patient.[uthsc.pure.elsevier.com]
  • Routine pathological examination of the explanted liver failed to reveal the etiology of the rupture.[scinapse.io]
  • The etiology of the hematoma is not entirely clear. Most of the authors claimed that it is caused by rupture of small caliber vessels due to the guidewire trauma [5] [6] [7] .[ijhpd.com]
  • Etiologies included traumatic hematoma in 10, tumor-related hematoma in 18, ruptured liver abscess in 20, biloma in 8, and 4 miscellaneous causes. CT typically showed a lenticular-shaped fluid collection compressing the liver parenchyma.[ncbi.nlm.nih.gov]
  • Ectopic pregnancy not within the (distal) fallopian tube: Etiology, diagnosis, and treatment. Am J Obstet Gynecol 2012;206:289-99. 9. Scazzocchio E, Figueras F, Crispi F, Meler E, Masoller N, Mula R, et al .[njcponline.com]

Epidemiology

  • Roberts, MD is Professor of Obstetrics and Gynecology and Epidemiology and Clinical and Translational Research at the University of Pittsburgh.[books.google.com]
Sex distribution
Age distribution

Pathophysiology

  • A review of the known and proposed risk factors, clinical signs and symptoms, pathophysiology, and treatment of both SBP and SLH are provided.[ncbi.nlm.nih.gov]
  • Gastrointestinal Surgery: Pathophysiology and Management is an invaluable reference text for surgeons and surgical trainees. Written entirely by Dr. Haile T.[books.google.com]
  • The pathophysiologic mechanism underlying the development of the hematoma is not clearly defined, however various authors agree that vascular injury of small-caliber intrahepatic vessels secondary to guidewire use may be the cause, which may also explain[elsevier.es]

Prevention

  • Is chronic lung disease in low birth weight infants preventable? A survey of eight centers. ‎ Página 84 - Tanner JM, Whitehouse RH, Marubini E, Resele LF. The adolescent growth spurt of boys and girls of the Harpenden growth study. ‎[books.google.es]
  • He led an NIH RCT (10,000 women) of antioxidant vitamins to prevent preeclampsia.[books.google.com]
  • As the guidewire may be sources of infection we recommend prophylactic broad spectrum antibiotics for these patients to prevent hematoma infection and abscess formation.[ijhpd.com]
  • X-ray control of the position of the guide-wire may prevent this rare complication of interventional ERCP.[thieme-connect.com]
  • She would also have been offered supplemental calcium to prevent pre-eclampsia, as stipulated in the South African maternity care guidelines. [7] A lesson to learn from her clinical presentation is that RSHL should be considered in any patient whose pregnancy[njcponline.com]

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