Kosin Med J.  2020 Dec;35(2):156-162. 10.7180/kmj.2020.35.2.156.

Subcapsular Hepatic Hematoma after Cardiopulmonary Resuscitation

Affiliations
  • 1Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea

Abstract

Cardiopulmonary resuscitation (CPR) is an important life-saving procedure in emergency care. However, CPR is associated with various complications. A 41-year-old man was admitted to the intensive care unit after CPR. A sudden decrease in the blood pressure and hematocrit level was recorded. An abdominal computed tomography (CT) showed a large subcapsular hematoma in the left lobe of the liver. With conservative treatment, the hematoma reduced in size, but it was later managed with percutaneous drainage. The patient recovered and was discharged. We obtained a favorable outcome with conservative, nonsurgical treatment. Subcapsular hepatic hematoma is a potential life-threatening complication that should be considered in CPR survivors.

Keyword

Cardiopulmonary resuscitation; Hematoma; Liver

Figure

  • Fig. 1 Abdominal computed tomography showing a large subscapular hematoma (17.8 × 7.9 cm2) in the left lobe of the liver (A) and small, diluted hemoperitoneum extending to the perisplenic space, mesenteric, and bilateral paracolic gutter and into the pelvic cavity

  • Fig. 2 (A) Follow-up abdominal computed tomography showing subtle decrease in the size of the subscapular hepatic hematoma (14.9 cm from 17.8 cm, in axial size) in the left lobe of the liver and no abnormal fluid collection, (B) Abdominal X-ray showing percutaneous insertion of an abdominal drainage catheter into the subcapsular hepatic hematoma

  • Fig. 3 After 1 month of PCD insertion, the follow-up CT showed decreased in size of large amount of subcapsular hematoma in left lobe of liver (17.8 cm from 9.0 cm, in axial size).


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