Gynecology and Obstetrics Service, Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias (Mother and Child University Hospital of the Canary Islands), Las Palmas de Gran Canaria, Spain.
General and Digestive Surgery Service, Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias (Mother and Child University Hospital of the Canary Islands), Las Palmas de Gran Canaria, Spain.
Am J Case Rep. 2023 Feb 25;24:e938169. doi: 10.12659/AJCR.938169.
BACKGROUND Endometriosis is a chronic inflammatory disease caused by endometrial tissue that grows outside the uterus. Deep endometriosis surgery is associated with considerable rates of complications, although such rates are lower in surgical procedures carried out by expert surgical teams. This report details a case of a rare but life-threatening complication in the postoperative period following 72 h of endometriosis surgery: a giant subcapsular hepatic hematoma, which was successfully managed conservatively. CASE REPORT Here we describe the case of a 39-year-old woman with deep endometriosis with ureteral, ovarian, and intestinal involvement requiring multidisciplinary surgery. She presented with severe anemia, respiratory distress, and oliguria 72 h postoperatively. A 3-phase computed tomography (CT) scan revealed a giant intrahepatic subcapsular hematoma (180×165×50 mm) lateral to the right hepatic lobe, which was managed conservatively. The patient evolved favorably and the hematoma was reduced (77×16 mm) in a follow-up CT scan performed 5 months later. CONCLUSIONS Giant liver hematoma is a rare, life-threatening complication. The current experience relating to its management remains largely limited owing to the rarity of the condition and paucity of published cases. Actually, we found no articles on hepatic hematoma in the context of endometriosis surgery. Early diagnosis and treatment are essential to reduce the patient's risk of death. Imaging diagnosis plays an essential role.
子宫内膜异位症是一种由子宫内膜组织在子宫外生长引起的慢性炎症性疾病。尽管在由专家手术团队进行的手术中，并发症的发生率较低，但深部子宫内膜异位症手术仍与相当高的并发症发生率相关。本报告详细介绍了一例罕见但危及生命的术后并发症病例：术后 72 小时发生的巨大包膜下肝血肿，经保守治疗成功处理。
本文描述了一名 39 岁的深部子宫内膜异位症患者，伴有输尿管、卵巢和肠道受累，需要多学科手术。她在术后 72 小时出现严重贫血、呼吸窘迫和少尿。3 期 CT 扫描显示右侧肝叶外侧有一个巨大的肝内包膜下血肿（180×165×50mm），采用保守治疗。患者病情好转，血肿在 5 个月后的后续 CT 扫描中缩小（77×16mm）。
巨大肝血肿是一种罕见的、危及生命的并发症。由于该病症的罕见性和发表病例的稀少，目前关于其治疗的经验仍然主要局限于文献。实际上，我们在子宫内膜异位症手术的背景下没有发现关于肝血肿的文章。早期诊断和治疗对于降低患者的死亡风险至关重要。影像学诊断起着至关重要的作用。
