Ando Yusuke, Ishigami Masatoshi, Ishizu Yoji, Kuzuya Teiji, Honda Takashi, Hayashi Kazuhiko, Ishikawa Tetsuya, Goto Hidemi, Hirooka Yoshiki
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan.
Clin J Gastroenterol. 2017 Jun;10(3):265-269. doi: 10.1007/s12328-017-0741-4. Epub 2017 Apr 26.
Liver compartment syndrome is a life-threatening complication of hepatic subcapsular hematoma; diagnosis and assessment of treatment effects are therefore important. We report a rare case of liver compartment syndrome due to spontaneous hepatic subcapsular hematoma without any underlying conditions, in which Doppler ultrasonography (US) proved useful in both diagnosis and assessment of treatment effects. A 32-year-old woman experienced sudden epigastralgia and was diagnosed with hepatic subcapsular hematoma in the right lobe, based on contrast-enhanced computed tomography. Hepatic arteriography showed active hemorrhage and Doppler US showed retrograde flow in the right portal vein. From these findings, we diagnosed hepatic subcapsular hematoma complicated with liver compartment syndrome, and performed embolization of the bleeding point and percutaneous hematoma drainage. After these medical procedures, normalized antegrade flow in the right portal vein was observed on Doppler US. No underlying conditions contributing to hematoma were identified. In this case, Doppler US was useful for both diagnosis and assessment of treatment effects in liver compartment syndrome. When we examine patients with hepatic subcapsular hematoma, Doppler US should be used to diagnose the presence of liver compartment syndrome and assess treatment effects.
肝间隔综合征是肝包膜下血肿的一种危及生命的并发症；因此，其诊断和治疗效果评估非常重要。我们报告一例罕见的因自发性肝包膜下血肿导致的肝间隔综合征病例，患者无任何基础疾病，其中多普勒超声检查（US）在诊断和治疗效果评估中均被证明是有用的。一名32岁女性突发上腹部疼痛，基于增强计算机断层扫描被诊断为右叶肝包膜下血肿。肝动脉造影显示有活动性出血，多普勒超声显示右门静脉有逆流。根据这些发现，我们诊断为肝包膜下血肿合并肝间隔综合征，并对出血点进行了栓塞和经皮血肿引流。这些医疗操作后，多普勒超声观察到右门静脉正向血流恢复正常。未发现导致血肿的基础疾病。在该病例中，多普勒超声在肝间隔综合征的诊断和治疗效果评估中均很有用。当我们检查肝包膜下血肿患者时，应使用多普勒超声来诊断肝间隔综合征的存在并评估治疗效果。
