Intrahepatic Subcapsular Hematoma Due to Pseudoanevrysm: A Rare Complication of Laparoscopic Cholecystectomy
Adil Chaouni
Department of Visceral Surgical Emergencies, Ibn Sina University Hospital, Rabat, Morocco.
Youssef Ouazzani Touhami *
Department of Visceral Surgical Emergencies, Ibn Sina University Hospital, Rabat, Morocco.
Fatima Zohra Ben Moula
Department of Visceral Surgical Emergencies, Ibn Sina University Hospital, Rabat, Morocco.
Yahya Zein EL Abidine Khedid
Department of Visceral Surgical Emergencies, Ibn Sina University Hospital, Rabat, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Aims: We report a rare case of intrahepatic subcapsular hematoma (ISH) following laparoscopic cholecystectomy (LC), successfully managed with endovascular embolization, and discuss its clinical implications and treatment options
Presentation of Case: A 59-year-old male presented with severe right upper quadrant pain 10 days after an uneventful LC. Clinical examination revealed pallor and tachycardia. Laboratory tests showed significant anemia. A contrast-enhanced CT scan revealed a large right-sided subcapsular liver hematoma measuring 21×10×8 cm with active bleeding from a ruptured pseudoaneurysm in segment VIII. The patient underwent urgent endovascular embolization. Post-procedural care included transfusion and close monitoring. He stabilized without the need for surgical intervention and was discharged uneventfully on the fourth day
Discussion: ISH is an uncommon but potentially life-threatening complication of LC. Its presentation is often delayed, and diagnosis requires a high index of suspicion. Management strategies depend on hemodynamic status, size of hematoma, and etiology. Embolization is a minimally invasive and effective treatment option
Conclusion: This case emphasizes the importance of early recognition and tailored management of ISH post-LC. It also highlights the role of embolization in avoiding surgical morbidity. Greater awareness of this rare complication can improve outcomes and guide future preventive strategies.
Keywords: Intra-hepatic subcapsular hematoma, laparoscopic cholecystectomy, complication, management