Subcapsular Hepatic Hematoma Research Articles

Etiology Of Spontaneous Perirenal Hemorrhage: A Meta-Analysis

Etiology Of Spontaneous Perirenal Hemorrhage: A Meta-Analysis

Short-stay, out-of-hospital, radiologically guided liver biopsy.

To evaluate the safety, the quality and adequacy of specimens obtained and the cost benefits associated with performing liver biopsy out of hospital, on a short-stay basis, using radiological guidance. A prospective study undertaken over a three-year period, from March 1998 to March 2001, in a private radiology practice. PATIENTS AND PROCEDURES: 251 patients (159 men) with stable liver disease participated. Coagulation studies were performed within a two-week period before biopsy, which was carried out under the guidance of ultrasound (143 patients) or computed tomography (108 patients). A disposable, spring-loaded gun with an 18-gauge biopsy needle was used in each case. A repeat ultrasound or CT scan was performed after the procedure to monitor for complications such as haemorrhage. Complications of liver biopsy; adequacy of specimens for histological examination; cost of out-of-hospital procedures compared with liver biopsies performed in the hospital setting. Two hundred and twenty nine patients (91.2%) were discharged 60 minutes after the biopsy. The only post-biopsy complication was pain, either at the biopsy site or in the right shoulder. Pain was severe in three patients and, for one of these patients, a subcapsular hepatic haematoma was found on ultrasound eight days after the biopsy. Sufficient material for histopathological examination was obtained from all patients. The cost of out-of-hospital biopsies was substantially less than the cost of hospital-based, day-stay procedures. Short-stay, out-of-hospital, radiologically guided liver biopsy is safe for patients who have stable chronic liver disease and acceptable coagulation profiles.

Group A streptococcal puerperal sepsis preceded by positive surveillance cultures

BACKGROUND: Screening of pregnant women for vaginal and rectal carriage of group B streptococci may also identify group A streptococcal carriers. The clinical significance of prenatal group A streptococcal carriage is unknown. CASES: Two women developed group A streptococcal puerperal sepsis after delivery at one hospital 15 months apart. The first patient required hysterectomy and suffered complications including subcapsular hepatic hematoma, pleural effusion, and prolonged ileus. She recovered after a 35-day hospitalization. The second patient had endometritis and recovered. Both had had group A streptococci isolated from vaginal and rectal cultures taken for prenatal group B streptococcal screening. The acute sepsis isolates were both M-type 28, but pulsed-field gel electrophoresis determined that the strains were unrelated. CONCLUSIONS: Finding group A streptococci on prenatal culture may presage serious postpartum infection.

Hematoma subcapsular hepático sintomático tras litotricia renal extracorpórea mediante ondas de choque

AbstractThe presentation of a hepatic subcapsular hematoma as a complication following the carrying out of an extracorporeal renal shock wave lithotripsy is fairly uncommon. We would like to describe the case of a patient who showed after extracorporeal renal post-lithotripsy intense abdominal symptoms and in which the presence of any prior hepatic pathology was ruled out, alterations in the blood coagulation system as well as anomalies in the execution of the extracorporeal lithotripsy as etiological mechanisms. We carried out a bibliographical review due to the rarity of the process described

Large Hepatic Hematoma and Intraabdominal Hemorrhage Associated with Abuse of Anabolic Steroids

To the Editor: Hepatocellular neoplasms, peliosis hepatis, and hepatic necrosis have been reported to be complications of long-term therapy with androgenic anabolic steroids.1 We report a case of a large subcapsular hepatic hematoma and subsequent intraabdominal hemorrhage associated with the abuse of anabolic steroids by a bodybuilder. A 24-year-old man was admitted to the hospital with right-upper-quadrant pain, mild tachycardia, hypertension, and oliguria. The patient reported a 23-month history of polydrug abuse to enhance the results of his bodybuilding exercises. He had been taking mesterolone (50 mg) daily and nandrolone (400 mg), clomiphene (50 mg), and chorionic gonadotropin (1250 IU) . . .

Imaging of subcapsular hepatic and renal hematomas in pregnancy complicated by preeclampsia and the HELLP syndrome

The purpose of this report is to provide an illustrative case of spontaneous hepatic and renal hematomas that occurred during a pregnancy complicated by preeclampsia and the HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome. The sonographic and computed tomographic findings included intrahepatic, subcapsular hepatic, and extracapsular perihepatic hematomas in addition to a large subcapsular renal hematoma. Since hepatic and renal hematomas that occur in association with preeclampsia and the HELLP syndrome are rare but potentially life-threatening complications, prompt laboratory and radiologic evaluations are essential and may reduce the associated morbidity and mortality.

Imaging of subcapsular hepatic and renal hematomas in pregnancy complicated by preeclampsia and the HELLP syndrome

The purpose of this report is to provide an illustrative case of spontaneous hepatic and renal hematomas that occurred during a pregnancy complicated by preeclampsia and the HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome. The sonographic and computed tomographic findings included intrahepatic, subcapsular hepatic, and extracapsular perihepatic hematomas in addition to a large subcapsular renal hematoma. Since hepatic and renal hematomas that occur in association with preeclampsia and the HELLP syndrome are rare but potentially life-threatening complications, prompt laboratory and radiologic evaluations are essential and may reduce the associated morbidity and mortality. © 1999 John Wiley & Sons, Inc. J Clin Ultrasound 27:35–40, 1999.

Budd-Chiari syndrome resulting from intrahepatic IVC compression secondary to blunt hepatic trauma

Hepatic venous outflow obstruction (Budd-Chiari syndrome)is a rare sequel of abdominal trauma. Three cases of Budd-Chiari syndrome resulting from obstruction to the intrahepatic IVC by liver injury are reported. The CT findings include extrinsic compression of the intrahepatic inferior vena cava (IVC) by intraparenchymal and/or subcapsular hepatic haematoma, non-visualization or narrowing of one or more main hepatic veins with intravenous contrast-enhanced CT, and accumulation of low attenuation ascites. This entity should be distinguished from intraperitoneal bile leak or hemoperitoneum associated with major liver injury with which it could be confused. Decompression of the IVC and hepatic veins by surgical or percutaneous drainage of intrahepatic or subcapsular hematoma was curative in two of the three patients.

Pitfalls of nonoperative management of blunt abdominal trauma in children in Korea

During the past decade, the nonoperative management of children with blunt abdominal trauma without operation has improved dramatically by virtue of the development of medical technology. However, missed injuries or complications after nonoperative management often are associated with serious morbidity. The authors evaluated 86 patients between 1990 and 1994 who had intraabdominal solid-organ injury (excluding retroperitoneal organs) owing to blunt trauma. The liver was injured in 43 cases, the spleen in 36, and the pancreas in 14. Initially, 68 patients (79%) were managed conservatively and 18 underwent surgery because of unstable vital signs or associated injuries. Three patients had delayed surgery more than 48 hours after trauma) because of initially missed injuries (complete infarction of the spleen, duodenal injury, major pancreatic injury). Eleven patients (17%) with nonoperative management had a total of 13 complications. The most common complications were pleural effusion (6) and atelectasis (3). One patient had prolonged ileus owing to delayed absorption of an intraperitoneal hematoma, and the symptom was relieved by aspiration of the hematoma. A huge hepatic subcapsular hematoma developed in another patient and required percutaneous drainage with a pigtail catheter for 5 weeks. A pancreatic pseudocyst detected on the 16th hospital day also was drained with a pigtail catheter. A splenic abscess developed in another patient 24 days after a splenic injury, which was treated with ultrasound-guided aspiration. No patients died as a result of nonoperative management. In conclusion, even though patients with blunt abdominal trauma are stabilized and nonoperative management decided on, careful follow-up for a prolonged period is still necessary to prevent missed injuries or late complications.

Hepatic lesions in the rabbit induced by acoustic cavitation

Tissue damage during shock-wave lithotripsy is presumably secondary to cavitation phenomena involving the collapsus of gas bubbles in a fluid. To enhance shock-wave-related hepatic lesions, intravascular gas microbubbles were administered. Three groups of eight rabbits each received either 500 shock waves focused on the right hepatic lobe (group 1), gas microbubbles as a mixture of 50 cm3 of air with 50 cm3 of gelatin infused through an arterial catheter (group 2), or 500 shock waves and gas microbubbles simultaneously (group 3). In group 1, two animals had two to three subcapsular hepatic hematomas (diameter, < 5 mm) and five had one to five intraparenchymal hematomas (< 1 mm). In group 2, a moderate liver congestion was observed in three animals. In group 3, all animals had numerous subcapsular and intraparenchymal hematomas (2–30 mm). The hematomas were centered around the portal spaces, associated with lacunae (0.5–5 mm in diameter). Hematomas were also present on the anterior wall of intraabdominal organs. It was concluded that intravascular infusion of gas microbubbles into the path of a shock-wave generator dramatically enhances tissue damage. This technique, potentially useful in the treatment of hepatic tumors, needs refinement to confine lesions in a more uniform pattern to the targeted parenchyma.

Hepatic Lesions in the Rabbit Induced by Acoustic Cavitation

Tissue damage during shock-wave lithotripsy is presumably secondary to cavitation phenomena involving the collapsus of gas bubbles in a fluid. To enhance shock-wave-related hepatic lesions, intravascular gas microbubbles were administered. Three groups of eight rabbits each received either 500 shock waves focused on the right hepatic lobe (group 1), gas microbubbles as a mixture of 50 cm3 of air with 50 cm3 of gelatin infused through an arterial catheter (group 2), or 500 shock waves and gas microbubbles simultaneously (group 3). In group 1, two animals had two to three subcapsular hepatic hematomas (diameter, less than 5 mm) and five had one to five intraparenchymal hematomas (less than 1 mm). In group 2, a moderate liver congestion was observed in three animals. In group 3, all animals had numerous subcapsular and intraperenchymal hematomas (2-30 mm). The hematomas were centered around the portal spaces, associated with lacunae (0.5-5 mm in diameter). Hematomas were also present on the anterior wall of intraabdominal organs. It was concluded that intravascular infusion of gas microbubbles into the path of a shock-wave generator dramatically enhances tissue damage. This technique, potentially useful in the treatment of hepatic tumors, needs refinement to confine lesions in a more uniform pattern to the targeted parenchyma.

Sudden Death Due to Delayed Rupture of Hepatic Subcapsular Hematoma Following Blunt Abdominal Trauma

Blunt abdominal trauma can cause sudden, unexpected death due to injuries to internal organs. Rupture of a hepatic subcapsular hematoma is a relatively rare cause of sudden death following minor blunt abdominal trauma. Death may be delayed several days to weeks. The autopsy is an invaluable diagnostic tool that can be utilized to uncover sudden deaths due to abdominal trauma. The case of an alcoholic who died of a ruptured hepatic subcapsular hematoma is presented. The death investigation revealed that the victim had sustained blunt abdominal trauma during a fall a few days prior to death.

Hepatic subcapsular hematoma: an unusual complication of biliary lithotripsy.

Clinical and sonographic features of a large subcapsular hematoma of the liver developed in a 49-year-old man within 24 hr of extracorporeal shock-wave lithotripsy for symptomatic gallstones. Prelithotripsy coagulation factors were normal. The procedure was performed with a second-generation lithotripter. An intercostal approach was used to target the shock-wave beam because of the retrocostal position of the gall bladder

Percutaneous catheter biliary decompression.

Percutaneous catheter biliary decompression was performed in 42 patients with obstructive jaundice. Internal drainage was accomplished in 27 patients (64.3%), and external drainage in 15 patients (35.7%). Serum bilirubin levels decreased at a mean rate of 1.4 mg/dl/day. Tissue diagnosis was obtained by percutaneous aspiration biopsy in nine patients (21.4%). Complications occurred in 10 patients (23.8%): septic shock, two; bilious pleural effusion, one; hepatic subcapsular hematoma, one; sepsis, six. There was one death related to the procedure. The catheter management problems encountered included pain, catheter dislodgement or migration, lumen occlusion, and external bile leakage.