Interventional Management of Subcapsular Hepatic Hematoma with Hepatic Compartment Syndrome After Laparoscopic Adrenalectomy

Cardiovasc Intervent Radiol. 2019 Apr;42(4):625-628. doi: 10.1007/s00270-018-02158-6. Epub 2019 Jan 2.


Hepatic compartment syndrome is an increase in intrahepatic pressure sufficient to cause compromised hepatic perfusion. Early recognition and prompt management are essential for preventing catastrophic consequences including ischemic liver failure and hypovolemic shock. This is the rare case of laparoscopic adrenalectomy resulting in subcapsular hepatic hematoma with hepatic compartment syndrome. Contrast-enhanced computed tomography demonstrated extensive subcapsular hepatic hematoma with collapse of portal vein and inferior vena cava suggesting impending compartment syndrome. Diagnostical catheter angiography of the liver revealed innumerable foci of petechial extravasation from disrupted isolated arteries. Emergent percutaneous catheter decompression and transarterial embolization were successful.

Keywords: Hepatic compartment syndrome; Laparoscopic adrenalectomy; Percutaneous catheter drainage; Subcapsular hepatic hematoma; Therapeutic embolization.

MeSH terms

  • Adrenalectomy / adverse effects*
  • Adult
  • Angiography
  • Drainage
  • Embolization, Therapeutic
  • Female
  • Hematoma / diagnostic imaging
  • Hematoma / therapy*
  • Humans
  • Intra-Abdominal Hypertension / diagnostic imaging
  • Intra-Abdominal Hypertension / therapy*
  • Laparoscopy / adverse effects*
  • Liver Diseases / diagnostic imaging
  • Liver Diseases / therapy*
  • Male
  • Multiple Endocrine Neoplasia Type 2a / surgery*
  • Portal Vein / diagnostic imaging
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / therapy*
  • Tomography, X-Ray Computed
  • Vena Cava, Inferior / diagnostic imaging