Causes for Liver Hematoma/Subcapsular fluid

Discussion in 'Gastroenterology' started by kateortamar, Apr 25, 2006.

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  1. kateortamar

    kateortamar Junior Member 5+ Year Member

    26
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    Sep 1, 2005
    USA
    From a non-GI resident, let me pick your collective brains:

    Other than trauma and iatrogenic causes due to procedures, what other causes can explain a liver hematoma or fluid collection beneath the capsule?
     
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  3. bariume

    bariume Member 7+ Year Member

    94
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    Jul 19, 2003
    Here's a few..
    Spontaneous hepatic cyst rupture - (simple cysts, cystadenomas,ecchinococcal);
    biliary leak and subsequent biloma;
    carcinoma eroding into a biliary or vascular structure.
     
  4. kateortamar

    kateortamar Junior Member 5+ Year Member

    26
    0
    Sep 1, 2005
    USA
    Okay, so the MRI shows no mass. There is no evidence of parasitic infection and there is no cause for a biliary leak.

    The ONLY findings on MRI are subcapsular fluid consistent with resolving hematoma. Again no trauma has occurred.
     
  5. Crypt Abscess

    Crypt Abscess Member 10+ Year Member

    93
    0
    Oct 13, 2002
    Interesting scenario- I favor cyst rupture (but they probably would have seen a cyst remant on MRI).

    How much fluid? Is the patient coagulopathic or on anti-coagulation? Is the patient symptomatic (RUQ pain)

    Maybe IR can stick a needle in it (ultrasound guided or GI-EUS) and see what it is.


     
  6. kateortamar

    kateortamar Junior Member 5+ Year Member

    26
    0
    Sep 1, 2005
    USA
    No coagulopathy and yes occasionally symptomatic to include RUQ soreness and R shoulder/back pain occasionally but not persistent.

    Also, the patient had pre-eclampsia 15 months ago.
     
  7. Iwy Em Hotep

    Iwy Em Hotep The Welcomer 10+ Year Member

    607
    4
    Aug 25, 2004
    Seattle
    Maybe a liver cell adenoma?
     
  8. DrNick2006

    DrNick2006 Senior Member 5+ Year Member

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    Oct 12, 2005
    Not advisable.

    I think the key word here is resloving.
     
  9. express

    express New Member

    1
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    May 15, 2006
    Question:

    what happens, when the patient has no prior symptoms, and suddenly one day feels excruciating abdominal pain?

    blood test shows everything is normal.

    ultrasound saw a small hemagioma.

    CT scan reveals masses (not distinct tumor)...but two shades of cell tissues...

    Patient feels bloating sensation and hardening beneath the diaphragm...

    No cancerous traits in the blood nor bone marrow...

    what can you say?...
     
  10. kateortamar

    kateortamar Junior Member 5+ Year Member

    26
    0
    Sep 1, 2005
    USA
    Actually after 2 months, an interim u/s was ordered and the patient has an increase of non-specific fluid (from 6 mm to 8 mm) located posterior right lobe. Again, no masses noted and the patient continues to have pain sporadically.
     
  11. Crypt Abscess

    Crypt Abscess Member 10+ Year Member

    93
    0
    Oct 13, 2002
    I would have to wonder about the signficance of 6-8mm of subcapsular fluid. Maybe MR of the liver would be able to sort things out. Crypt
     

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