Spontaneous Subcapsular Hepatic Haematoma: A Rare Case Report

Roisin Burrows-O’Donoghue, Rowena Donnison, Emmanuel D’Almeida
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Abstract

A spontaneous subscapular hepatic haematoma is a rare condition that has not widely been reported in literature. Subscapular hepatic haematoma has a high mortality rate, especially if the haematoma ruptures, so early diagnosis is imperative. In this case report, the authors present an unusual case of subscapular hepatic haematoma of a female in her 70s, who, in her first few days of admission for the management of acute calculus cholecystitis, developed acute onset right upper quadrant and epigastric pain radiating to her back. Her haemoglobin dropped from 112 g/L to 54 g/L, and her liver function tests and coagulation studies became deranged. Abdominal and pelvic CT and angiography showed a subscapular liver haematoma without active bleeding. The patient received a blood transfusion and was managed conservatively, with no obvious cause being identified.
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自发性肝囊下血肿:罕见病例报告
自发性肩胛下肝血肿是一种罕见病症,文献报道不多。肩胛下肝血肿的死亡率很高,尤其是当血肿破裂时,因此必须及早诊断。在本病例报告中,作者介绍了一例不寻常的肩胛下肝血肿病例,患者是一名 70 多岁的女性,在入院治疗急性结石性胆囊炎的头几天,出现了急性发作的右上腹和上腹部疼痛,并向背部放射。她的血红蛋白从 112 克/升降至 54 克/升,肝功能检查和凝血功能检查也出现异常。 腹部和盆腔 CT 及血管造影术显示肩胛下肝血肿,但无活动性出血。患者接受了输血,并接受了保守治疗,没有发现明显的病因。
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