Malle Mahamadou, Kone Youssouf
Service de Radiologie, Hôpital Régional de Gao, Gao, Mali.
Service de Radiologie, Centre Hospitalier Universitaire du Point « G » de Bamako, Bamako, Mali.
Pan Afr Med J. 2019 Dec 9;34:187. doi: 10.11604/pamj.2019.34.187.20096. eCollection 2019.
Rupture of spontaneous subcapsular hematoma of the liver is very rare and therefore it has been rarely described in the literature. It generally occurs among women with underlying liver disease or often, during pregnancy, in women with HELLP syndrome. We here report the case of a 60-year old man with no particular past medical history presenting with large subcapsular haematoma of the liver. He was admitted to the Emergency Department with moderate-intensity right hypochondre pain evolving over the last week, which was aggravated, two days before, by influenza-like illness associating cough, yellowish sputum and sweatings. Clinical examination showed abdominal tenderness on palpation of the right hypochondre and hypogastrium. The remainder of the clinic examination was normal. Laboratory tests showed hemoglobin level 7.8g/dl, MCV: 79.9, reticulocyte count 48.9. computed tomography (CT) scan showed voluminous subcapsular hematoma of the liver measuring 17cm in height, 14cm in cross-sectional diameter and 5cm in thickness and a hepatic nodule measuring 10mm (A) with hemoperitoine of great abundance without active bleeding (B). The patient underwent visceral surgery (laparotomy) with favorable postoperative outcome.
自发性肝包膜下血肿破裂非常罕见，因此在文献中很少被描述。它通常发生在患有潜在肝脏疾病的女性中，或者经常在怀孕期间，发生在患有HELLP综合征的女性中。我们在此报告一例60岁男性病例，该患者无特殊既往病史，出现巨大肝包膜下血肿。他因右季肋部中度疼痛持续一周而被收入急诊科，两天前因伴有咳嗽、黄色痰液和出汗的流感样疾病而加重。临床检查发现右季肋部和下腹部触诊时有压痛。其余临床检查正常。实验室检查显示血红蛋白水平为7.8g/dl，平均红细胞体积（MCV）：79.9，网织红细胞计数48.9。计算机断层扫描（CT）显示肝脏有巨大的包膜下血肿，高17cm，横径14cm，厚5cm，还有一个10mm的肝结节（A），腹腔内有大量积血且无活动性出血（B）。患者接受了内脏手术（剖腹手术），术后恢复良好。
