• 한국간담췌외과학회지
• /
• 제28권3호
• /
• pp.283-290
• /
• 2024

Hepatic compartment syndrome (HCS) is a rare but life-threatening entity that consists of a decreased portal flow due to intraparenchymal hypertension secondary to subcapsular liver hematoma. Lethal liver failure can be observed. We report three cases, and review the literature. A 54-year-old male was admitted for extensive hepatic subcapsular hematoma after blunt abdominal trauma. Initially, he underwent embolization of the hepatic artery's right branch, after which he presented clinical deterioration, major cytolysis (310 times the upper limit of normal [ULN]), and liver failure with a prothrombin time (PT) at 31.0%. A 56-year-old male underwent liver transplantation for acute alcoholic hepatitis. On postoperative day 2, he presented a hemorrhagic shock associated with deterioration of liver function (cytolysis 21 ULN, PT 39.0%) due to extensive hepatic subcapsular hematoma. A 59-year-old male presented a hepatic subcapsular hematoma five days after a cholecystectomy, revealed by abdominal pain with liver dysfunction (cytolysis 10 ULN, PT 63.0%). All patients ultimately underwent urgent surgery for liver capsule excision, hematoma evacuation, and liver packing, if needed. The international literature was screened for this entity. These three patients' outcomes were favorable, and all were alive at postoperative day 90. The literature review found 15 reported cases. HCS can occur after any direct or indirect liver trauma. Surgical decompression is the main treatment, and there is probably no place for arterial embolization, which may increase the risk of liver necrosis. A 13.3% mortality rate is reported. HCS is a rare complication of subcapsular liver hematoma that compresses the liver parenchyma, and leads to liver failure. Urgent surgical decompression is needed.

• Clinical and Experimental Pediatrics
• /
• 제51권1호
• /
• pp.89-92
• /
• 2008

신생아의 피막하 간 혈종은 다양한 원인에 의해서 유발되는데 대부분은 출혈의 양이 적어 임상적으로 발견되기 보다는 부검시 발견되는 경우가 많다. 그러나 출혈의 양이 많아 혈종을 싸고 있는 피막이 파열되고 잇따른 출혈이 발생할 경우에는 창백, 혈관 허탈, 빈혈, 복부팽만, 저산소증, 산혈증 등의 증상을 보이므로 조기에 의심하여 정확한 진단을 내리고 적절한 수술적 치료를 실시하지 않으면 사망률이 높다. 저자들은 태변 흡입후 신생아 가사 소견을 보여 심폐소생술을 실시한 신생아에서 출생후 7일에 발현된 대량 피막하 간 혈종 파열 1례를 경험하였기에 보고하는 바이다.