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A 39-Year-Old Woman with Endometriosis Who Developed a Subcapsular Liver Hematoma Following Laparotomic Surgical Left Adnexectomy, Rectosigmoid Anastomosis, and Bilateral Ureteral Reimplantation.

Authors :
Sánchez Sánchez MV
Santana Suárez MA
Ocón Padrón L
García Anguiano F
Archilla Andrés E
Martínez Barreto C
Pérez Morales ME
Martín Martínez AI
Source :
The American journal of case reports [Am J Case Rep] 2023 Feb 25; Vol. 24, pp. e938169. Date of Electronic Publication: 2023 Feb 25.
Publication Year :
2023

Abstract

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.

Details

Language :
English
ISSN :
1941-5923
Volume :
24
Database :
MEDLINE
Journal :
The American journal of case reports
Publication Type :
Academic Journal
Accession number :
36840346
Full Text :
https://doi.org/10.12659/AJCR.938169