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Hepatic subcapsular hematoma after extracorporeal shock wave lithotripsy (ESWL) for pancreatic stones
Authors:Nobuto Hirata  Yona Kushida  Takehiko Ohguri  Satoshi Wakasugi  Toshihiro Kojima  Rikiya Fujita
Affiliation:(1) Department of Gastroenterology, Sagamidai Hospital, 6-24-28 Sagamigaoka, Zama 228-0001, Japan, JP;(2) Department of Gastroenterology, Fujigaoka Hospital, Yokohama, Japan, JP
Abstract:We present a patient with complication of huge hepatic subcapsular hematoma after extracorporeal shock wave lithotripsy (ESWL) for pancreatic lithotripsy. The hematoma measured 78–110 mm. Angiography showed a subcapsular hematoma, rather than a hematoma in the liver. In the arterial phase, the distal end of the small vessel showed spotty opacification similar to microaneurysma, suggesting that it was an injury caused by separation of the liver and its capsule, caused by the shock waves. The portal vein and hepatic vein were normal. After 8 weeks of conservative therapy, the hematoma was gradually absorbed and the patient was discharged. Eight months after the accident, the hematoma had decreased to 40 mm in size. After 20 months, it was completely absorbed. The reported rate of renal subcapsular hematoma after ESWL for renal or ureter stones is 0.1%–0.7%. To date, however, only five cases of hepatic subcapsular hematoma after right renal stone disintegration have been reported. This is the first report of hepatic subcapsular hematoma after ESWL for pancreatic stones. Received: September 11, 1998 / Accepted: April 16, 1999
Keywords:: pancreatic stone  ESWL  complication  hepatic subcapsular hematoma
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