Abstract
We present a case of hepatic ischemia due to the tamponade effect of a hepatic subcapslar hematoma, which was treated by transcatheter arterial embolization (TAE). Sudden cardiac arrest occurred in a 60-year-old woman at a sports meeting and bystander cardiopulmonary resuscitation (CPR) was performed immediately. She regained a spontaneous circulation by the defibrillation, and was transferred to our emergency department. She was diagnosed with acute myocardial infarction (AMI) by coronary angiography (CAG), and percutaneous coronary intervention (PCI) was performed. After she was taken to ICU, her circulation was unstable and anemia proceeded. Two days after her admission, an abdominal computed tomography (CT) showed a subcapsular and intraparenchymal hematoma in the right lobe of the liver and intraparenchymal hematoma in the left lobe. The right lobe was not enhanced equally in a contrast media study because of the intraparenchymal hypertension due to subcapsular hematoma. We diagnosed this case as liver compartment syndrome. Her serum transaminase increased dramatically compared to that on arrival, so hepatic ischemia obviously existed at that time. TAE was performed and her circulation became stable. Though it is said that the surgical decompression is required in a case of liver compartment syndrome when any signs of hepatic ischemia are present, we successfully managed this case non-operatively.
