Spontaneous large liver haematoma with extensive intraperitoneal bleeding in a patient with COVID-19 infection

BMJ Case Rep. 2022 Jul 25;15(7):e249256. doi: 10.1136/bcr-2022-249256.

Abstract

Thrombotic complications during COVID-19 infections occur frequently, and anticoagulants to prevent and treat deep vein thrombosis appear to have a good safety profile in these patients. In addition, haemorrhagic complications during COVID-19 infections have also been reported. Hepatic inflammation can occur in COVID-19 infections as a direct consequence of cellular infection and cytopathy. Spontaneous subcapsular hepatic haematoma is extremely rare and can be life-threatening.A woman in her 40s presented to the hospital with fever and shortness of breath and was diagnosed with COVID-19 infection with respiratory failure requiring intubation. On day 49 of hospitalisation, she developed melena and acute anaemia; her haemoglobin dropped from 97g/L (9.7g/dL) to 56g/L (5.6g/dL). Abdominal and pelvic CT scans showed a large subcapsular liver haematoma with retroperitoneal extension. The patient received blood transfusions and remained haemodynamically stable. She was eventually extubated and discharged home.

Keywords: COVID-19; Liver disease; Medical management; Radiology.

Publication types

  • Case Reports

MeSH terms

  • Anticoagulants / therapeutic use
  • COVID-19* / complications
  • Female
  • Gastrointestinal Hemorrhage / complications
  • Hematoma / diagnostic imaging
  • Hematoma / etiology
  • Hematoma / therapy
  • Hemoperitoneum / complications
  • Humans
  • Liver Diseases* / complications

Substances

  • Anticoagulants