A CASE OF TRAUMATIC BLUNT HEPATIC INJURY WITH HEPATIC COMPARTMENT SYNDROME DUE TO AN ACUTE INCREASE OF HEPATIC SUBCAPSULAR HEMATOMA

Abstract

　　Type Ia liver injury is often treated conservatively with few complications. We encountered a case of hepatic compartment syndrome due to an acute increase of the hepatic subcapsular hematoma after conservative treatment. A 21-year-old man was injured when hit by moving car. Computed tomography (CT) on admission revealed a type Ia liver injury in the right lobe of the liver and conservative treatment was performed. Subsequently, the patient complained of right upper abdominal pain. CT was repeated, revealing an acute increase of the hepatic subcapsular hematoma. Therefore, vascular embolization was performed. The condition was diagnosed as hepatic compartment syndrome due to hepatic subcapsular hematoma. The patient was discharged without complications. This case shows that even mild liver injury can lead to rapid subcapsular hematoma formation ; hence, careful observation of such cases is warranted.