A case of liver subcapsular spontaneous biloma treated with attention for hemostasis of isolated artery of liver

Abstract

A male in his 70s referred from nearby hospital with the symptom of right hypochondrial pain, with suspicion of acute cholecystitis and liver subcapsular hematoma. Enhanced CT revealed high density area at neck of gallbladder, suggesting cholecystolithiasis with swollen gallbladder. In addition, liver subcapsular fluid collection with high density niveau, suggesting hematoma was detected. Thus, we diagnosed as spontaneous liver subcapsular biloma, complicated with subcapsular hemorrhage, due to acute cholecystitis. We performed emergent cholecystectomy, with hemostasis of liver subcapsular hemorrhage by electric cautery, especially paid attention for isolated artery of the liver. For treatment of liver subcapsular spontaneous biloma, not only cause of biloma, but also isolated artery of the liver should be paid attention for safe and efficacy surgical treatment.