Subcapsular Liver Hematoma after Colonoscopy Diagnosed by Emergency Department Bedside Ultrasonography

Subcapsular Liver Hematoma after Colonoscopy Diagnosed by Emergency Department Bedside... Introduction</h5> The presentation of a hepatic subcapsular hematoma has a multitude of etiologies, ranging from traumatic, obstetric, vascular, neoplastic, and iatrogenic, among others. Patients typically present with right upper quadrant abdominal pain, which may include signs and symptoms of shock if the bleeding is severe. Thus, it is important to recognize this diagnosis in the Emergency Department (ED). Although computed tomography is the preferred imaging modality for diagnosis, rapid bedside ultrasonography is an effective tool to narrow the differential diagnosis and identify the lesion. We will discuss a case of a hepatic subcapsular hematoma that presented several hours after a diagnostic colonoscopy.</P>Case Report</h5> A 30-year-old woman presented to the ED with severe epigastric and right upper quadrant pain radiating to the right scapula after a colonoscopy 6 h prior. The patient was otherwise well before the procedure, and the pain began shortly after the colonoscopy was performed. She also complained of one episode of non-bilious, non-bloody emesis and watery diarrhea with scant rectal bleeding after the procedure. The patient had been observed in the post-op care unit after the colonoscopy, with no improvement in pain, and was sent to the ED by her gastroenterologist to obtain imaging for http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Emergency Medicine Elsevier

Subcapsular Liver Hematoma after Colonoscopy Diagnosed by Emergency Department Bedside Ultrasonography

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Publisher
Elsevier
Copyright
Copyright © 2013 Elsevier Inc.
ISSN
0736-4679
D.O.I.
10.1016/j.jemermed.2013.04.024
Publisher site
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Abstract

Introduction</h5> The presentation of a hepatic subcapsular hematoma has a multitude of etiologies, ranging from traumatic, obstetric, vascular, neoplastic, and iatrogenic, among others. Patients typically present with right upper quadrant abdominal pain, which may include signs and symptoms of shock if the bleeding is severe. Thus, it is important to recognize this diagnosis in the Emergency Department (ED). Although computed tomography is the preferred imaging modality for diagnosis, rapid bedside ultrasonography is an effective tool to narrow the differential diagnosis and identify the lesion. We will discuss a case of a hepatic subcapsular hematoma that presented several hours after a diagnostic colonoscopy.</P>Case Report</h5> A 30-year-old woman presented to the ED with severe epigastric and right upper quadrant pain radiating to the right scapula after a colonoscopy 6 h prior. The patient was otherwise well before the procedure, and the pain began shortly after the colonoscopy was performed. She also complained of one episode of non-bilious, non-bloody emesis and watery diarrhea with scant rectal bleeding after the procedure. The patient had been observed in the post-op care unit after the colonoscopy, with no improvement in pain, and was sent to the ED by her gastroenterologist to obtain imaging for

Journal

Journal of Emergency MedicineElsevier

Published: Oct 1, 2013

References

  • Subcapsular hepatic hematoma revealed by hemorrhagic shock in a preeclamptic patient
    Zidouh, S.; Belymani, L.; Kouach, J.
  • Sonographic diagnosis of subcapsular liver hematoma mimicking tumor in a neonate
    Mouratidis, B.; Antonio, G.

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