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Interventional Management of Subcapsular Hepatic Hematoma with Hepatic Compartment Syndrome After Laparoscopic Adrenalectomy

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Abstract

Hepatic compartment syndrome is an increase in intrahepatic pressure sufficient to cause compromised hepatic perfusion. Early recognition and prompt management are essential for preventing catastrophic consequences including ischemic liver failure and hypovolemic shock. This is the rare case of laparoscopic adrenalectomy resulting in subcapsular hepatic hematoma with hepatic compartment syndrome. Contrast-enhanced computed tomography demonstrated extensive subcapsular hepatic hematoma with collapse of portal vein and inferior vena cava suggesting impending compartment syndrome. Diagnostical catheter angiography of the liver revealed innumerable foci of petechial extravasation from disrupted isolated arteries. Emergent percutaneous catheter decompression and transarterial embolization were successful.

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Abbreviations

CT:

Computed tomography

POD:

Postoperative day

IVC:

Inferior vena cava

DSA:

Digital subtraction angiography

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Authors and Affiliations

  1. Department of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan-si, Republic of Korea

    Hyoung Nam Lee & Woong Hee Lee

  2. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Sung Gi Cho

Authors
  1. Hyoung Nam Lee
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  2. Sung Gi Cho
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  3. Woong Hee Lee
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Correspondence to Hyoung Nam Lee.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study. Consent for publication was obtained for every individual person’s data included in the study.

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Lee, H.N., Cho, S.G. & Lee, W.H. Interventional Management of Subcapsular Hepatic Hematoma with Hepatic Compartment Syndrome After Laparoscopic Adrenalectomy. Cardiovasc Intervent Radiol 42, 625–628 (2019). https://doi.org/10.1007/s00270-018-02158-6

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  • DOI: https://doi.org/10.1007/s00270-018-02158-6

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