Abstract
Bleeding manifestations, usually cutaneous or gastrointestinal - are common in liver cirrhosis. Spontaneous intracerebral and intramuscular bleeds are reported uncommonly, often associated with gross hepatic dysfunction and severely deranged hemostatic parameters, and are often markers to imminent mortality. Male sex, alcoholic etiology, significant thrombocytopenia, severe coagulopathy, and advanced liver disease are common denominators in patients with spontaneous intramuscular bleed. We here report three cases of spontaneous muscle hematomas complicating hepatic cirrhosis. To the best of our knowledge, this is the largest single center series reporting spontaneous muscle hematomas complicating cirrhosis from the Indian subcontinent.
This is a preview of subscription content, log in via an institution to check access.
References
Kujovich JL. Hemostatic defects in end stage liver disease. Crit Care Clin. 2005;21:563–87.
Blake JC, Sprengers D, Grech P, et al. Bleeding time in patients with hepatic cirrhosis. BMJ. 1990;301:12–5.
Violi F, Leo R, Vezza E, et al. Bleeding time in patients with cirrhosis: relation with degree of liver failure and clotting abnormalities. J Hepatol. 1994;20:531–6.
Hu KQ, Yu AS, Tiyyagura L, et al. Hyperfibrinolytic activity in hospitalized cirrhotic patients in a referral liver unit. Am J Gastroenterol. 2001;96:1581–6.
Stein SF, Harker LA. Kinetic and functional studies of platelets, fibrinogen, and plasminogen in patients with hepatic cirrhosis. J Lab Clin Med. 1982;99:217–30.
Sugiyama C, Akai A, Yamakita N, Ikeda T, Yasuda K. Muscle hematoma: a critically important complication of alcoholic liver cirrhosis. World J Gastroenterol. 2009;15:4457–60.
Kamura M, Tanahashi T, Yamakita N, Ikeda T. A case of idiopathic iliopsoas hematoma associated with liver cirrhosis. Nippon Shokakibyo Gakkai Zasshi. 1998;95:1266–9.
Huang HH, Lin HH, Shih YL, et al. Spontaneous intracranial hemorrhage in cirrhotic patients. Clin Neurol Neurosurg. 2008;110:253–8.
Horak JK, Brandon TA, Ribeiro LG, Ware JA, Miller RR, Solis RT. Effects of ethanol and hemolysis on in vivo and in vitro platelet aggregation. J Cardiovasc Pharmacol. 1982;4:1037–41.
de Lange DW, Hijmering ML, Lorsheyd A, et al. Rapid intake of alcohol (binge drinking) inhibits platelet adhesion to fibrinogen under flow. Alcohol Clin Exp Res. 2004;28:1562–8.
Tozawa H, Kobayashi S, Muramatsu A, Hasegawa C, Hayakawa T. A case of alcoholic liver cirrhosis associated with intramuscular hematoma. Nippon Shokakibyo Gakkai Zasshi. 2006;103:839–43.
Docherty JG, Herrick AL. Bilateral rectus sheath haematoma complicating alcoholic liver disease. Br J Clin Pract. 1991;45:289.
Yoshida H, Tsuji K, Kawakami H, et al. Two cases of alcoholic liver cirrhosis associated with intramuscular hematoma. Nippon Shokakibyo Gakkai Zasshi. 2002;99:1350–4.
Conflict of interest
GSZ, RR, PS, SK, and TMR hereby declare that they have no conflict of interest associated with this publication.
Ethics statement
The authors hereby declare that the study was performed in a manner to conform with the Helsinki Declaration of 1975, as revised in 2000 and 2008, concerning human and animal rights and that the authors followed the policy concerning informed consent as shown at www.springer.com.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zacharia, G.S., Ray, R., Sivaprasad, P. et al. Muscle hematomas: Uncommon but horrendous complication of cirrhosis liver. Indian J Gastroenterol 33, 289–291 (2014). https://doi.org/10.1007/s12664-013-0438-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12664-013-0438-7