Postpartum spontaneous subcapsular hepatic hematoma. Hematoma subcapsular por fasciolasis liver subcapsular. Hematoma subcapsular hepatico roto en sindrome hellp. Because of the difficulty in diagnosing hepatic rupture in pregnant women, it is often associated with a high mortality rate. Blood serological tests were positive for fasciola hepatica. A subcapsular hematoma related to endoscopic retrograde cholangiopancreatography is an infrequent entity. Rotura hepatica, hematoma hepatico, sindrome hellp. Fasciolasis, hematoma subcapsular hepatico espontaneo, eosinofilia. Hellp syndrome complicated by subcapsular hematoma of. The spleen, kidneys apart from right superior pole cortical scar, pancreas, duodenum, gbbile ducts adrenals have normal appearances.
Endoscopic retrograde cholangiopancreatography is a very common therapeutic procedure for a variety of biliary and pancreatic duct diseases. 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. Spontaneous hepatic rupture during labour is a rare condition. Imaging of nontraumatic hemorrhagic hepatic lesions. The hematoma is usually located around the right lobe of the liver in 75% of patients. A subcapsular hematoma of the liver is an accumulation of blood between glissons capsule and the liver parenchyma. There are a lot of therapeutic options varying from conservative management to surgical treatment including hepatic. Subcapsular hepatic hematoma secondary to endoscopic retrograde. Initial laboratory showed leukocytosis with 56% of eosinophils. 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. Broken hepatic subcapsular hematoma in the course of hellp syndrome.
The most common reported complications are pancreatitis, bleeding, perforation, and infection. Sangrado activo espontaneo abdominal en pacientes ambulantes. Subcapsular hepatic hematoma in an otherwise uncomplicated pregnancy. Although pregnant women with hellp syndrome are more prone to hepatic rupture, it can also occur with other liver. Liver subcapsular hematoma caused by fasciola hepatica. Procedure related complications are more frequent than in other endoscopic procedures. Hematoma hepatico subcapsular roto en sindrome hellp. This case report is about a pregnant patient, 38 years old, previous hypertension addimited to blood pressure control and presented hepatic hemorrhage due to hellp syndrome. Spontaneous retroperitoneal hematoma causing abdominal pain and hemorrhagic shock. 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. Para evaluar la posible rotura se le realizo una laparoscopia, que descarto la hipotesis. Medicina intensiva vol 32, issue 9, pages 411456 december. Pdf hematoma hepatico espontaneo en embarazo gemelar caso.
Ruptured hepatic subcapsular hematoma and hypovolemic shock as an unusual complication after endoscopic retrograde cholangiopancreatography. Liver segment 7 subcapsular area, measuring 6mm in depth. Nonenhanced ct scan shows a large, mostly hyperattenuating, acute subcapsular hematoma arrow. The ultrasound appearance of hepatic hematoma changes with time. The patient was operated and the presence of a subcapsular hematoma was confirmed. An abdominal cat sean showed a subcapsular fluid collection in the liver. Hipertensao gestacional conduzir como a preeclampsia leve. Subcapsular hepatic hematoma is the accumulation of blood between the capsule of glisson and the liver parenchyma. The diagnostic contribution of ct, us and ceus the change of the therapeutic management in abdominal hemorrhages, from an invasive approach towards a nonsurgical one, an aspect which has presented an increased.
Ruptured hepatic subcapsular hematoma, endoscopic retrograde cholangiopancreatography, cholecholithiasis. The treatment of hepatic rupture is basically surgical. These outcomes are often fulminant evolution, and maternal mortality amounted to more than 50%. Hyp e rreninemic hypertension secon dary to a subcapsular perinephric hematoma in a patient with polyarteritis nodosa. Perez ac, martinez wm, hoefler ss, mollo ea, campana gv, czwiklitzer gs. Subcapsular liver hematoma slh is a rare complication of severe preeclampsia and hellp syndrome. Remarkably, the etiopathogenesis still remains unclear. Hematoma subcapsular hepatico roto asociado a preeclampsia severa y sindrome hellp como urgencia quirurgica. The subcapsular hematoma is a serious complication, with high risk of maternal and neonatal mortality, it is seen as a. It is usually hyperechoic in the acute phase, whereas it appears inhomogeneously hypoechoic, with internal echoes due to septation and debris, in a more.
Subcapsular liver hematoma and hepatic rupture are a rare but disastrous consequence of hellp syndrome. Embarazo a termino posterior a ruptura hepatica secundaria a. Hematoma subcapsular, no expansivo, hematoma 10 a 50%. Spontaneous retroperitoneal and subcapsular liver hematoma. Tc axial con contraste intravenoso en fase arterial izquierda y venosa derecha. An interesting hypothesis is based on the formation of fibrin thrombus within the hepatic arteries and sinusoid capillaries which in turn leads to. Subcapsular liver hematoma hepatic subcapsular hematoma. Descriptive, retrospective study, series of cases type. Spontaneous subcapsular liver hematoma associated with pregnancy.
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