A Case of Intraabdominal Chronic Expanding Hematoma Treated by Laparoscopy-assisted Resection

Abstract

The case involved a 78-year-old man who underwent laparotomic cholecystectomy for gallbladder stone at the age of 45. Abdominal CT scan performed for aggravated chronic renal failure disclosed a 5.2-cm diameter intraabdominal tumor adjacent to the subhepatic space (S5-S6). The tumor had a thick capsule with calcification and the border with the liver was kept intact. Although a possibility of a tumor arisen in the liver could not be ruled out completely, we first suspected it to be a mesenteric tumor and performed surgery. During surgery the tumor was found to form a conglomerated mass with the liver and the ascending colon, and laparoscopy-assisted partial hepatectomy was performed including partial resection of the serosal muscle layer of the ascending colon. On histopathology, there were no tumor cells, the center part was mainly composed of a degenerated hematoma, and neovascularization and fresh red blood cells were seen within the hematoma and inside of the capsule. Chronic expanding hematoma was thus diagnosed. The patient's postoperative course was uneventful. He is not on hemodialysis and no signs of recurrence have been seen up to now.
This paper deals with a case of intraabdominal chronic expanding hematoma, a rare entity, for which laparoscopy-assisted resection was performed.