Subcapsular hematoma resulting in hepatic ischemia as a complication of necrotizing pancreatitis

David P Duncan; Amanda K Briese; Stephen Niemiec; Rebekah White; Andrew C Picel; Michael E Hahn

doi:10.1016/j.radcr.2019.12.021

Subcapsular hematoma resulting in hepatic ischemia as a complication of necrotizing pancreatitis

Radiol Case Rep. 2020 Jan 20;15(4):316-320. doi: 10.1016/j.radcr.2019.12.021. eCollection 2020 Apr.

Authors

David P Duncan¹, Amanda K Briese², Stephen Niemiec³, Rebekah White³, Andrew C Picel^{1

4}, Michael E Hahn¹

Affiliations

¹ Department of Radiology, University of California, 200 West Arbor Drive, La Jolla, San Diego, CA 92103, USA.
² Lake Erie College of Osteopathic Medicine, Bradenton, FL, USA.
³ Department of Surgery, University of California, San Diego, La Jolla, CA, USA.
⁴ Department of Radiology, Stanford University, Palo Alto, CA, USA.

Abstract

This report presents a case of necrotizing pancreatitis resulting in a large hepatic subcapsular hematoma that led to development of hepatic ischemia and early stages of liver failure. Following surgical decompression, liver function dramatically improved, but large areas of peripheral hepatic infarction had developed. This case demonstrates the risks of a rapidly expanding hepatic subcapsular hematoma, emphasizes the importance of recognizing and aggressively treating active bleeding, and cautions against administering anticoagulation and tissue-plasminogen activator in this clinical scenario.

Keywords: Hepatic hematoma; Hepatic infarct; Necrotizing pancreatitis.

Publication types

Case Reports