A liver hematoma is a collection of blood within or around the liver. While some are minor and resolve without intervention, others can be severe and pose life-threatening complications. Prompt medical evaluation is important to determine its nature and severity, ensuring appropriate management.
What is a Liver Hematoma?
A liver hematoma is an accumulation of blood within the liver’s functional tissue or its outer capsule. This occurs when blood vessels within the liver are damaged, leading to internal bleeding.
Liver hematomas are classified by location. An intrahepatic hematoma is within the liver tissue, while a subcapsular hematoma forms beneath Glisson’s capsule, the liver’s thin, fibrous outer covering. The severity of these blood collections can vary significantly, from small, contained pools to large, expanding masses of blood.
Common Causes and Recognizable Symptoms
Liver hematomas frequently arise from blunt abdominal trauma, such as injuries sustained in car accidents or falls. Medical procedures involving the liver, including biopsies or certain surgeries, can also lead to their formation. Underlying medical conditions can contribute to liver hematomas, including tumors, pre-eclampsia (a pregnancy complication), and disorders affecting blood clotting.
Symptoms are often non-specific, meaning they can be indicative of various conditions. Abdominal pain, particularly in the upper right side, is a common symptom. Individuals might also experience swelling or tenderness in the abdomen, nausea, and vomiting. Signs of significant internal bleeding can include dizziness, a rapid heart rate, or pale skin, signaling a more severe situation.
How Liver Hematomas Are Diagnosed
Diagnosing a liver hematoma involves a combination of physical examination and imaging studies. Ultrasound is often used as an initial screening tool to detect fluid collections within the abdomen, though it may not fully characterize the extent of a liver injury. Computed Tomography (CT) scans are effective for identifying and grading liver injuries, revealing the size, location, and nature of the hematoma. Magnetic Resonance Imaging (MRI) can also provide detailed images of liver lesions and is sometimes used to further assess the hematoma’s characteristics.
Blood tests complement imaging by providing information about the patient’s overall condition. A complete blood count (CBC) can indicate anemia due to blood loss, while liver function tests assess the liver’s health and any impact from the hematoma. These laboratory results, combined with imaging findings, help medical professionals determine the severity of the hematoma and guide treatment decisions.
Treatment Options and Management
The management of a liver hematoma is individualized, depending on its size, cause, and the patient’s overall health stability. For smaller, stable hematomas, conservative management is often the preferred approach. This involves close observation, rest, and continuous monitoring to ensure the hematoma does not grow or cause further complications.
When bleeding persists or the hematoma expands, interventional procedures may become necessary. Angiographic embolization, a minimally invasive technique, can block blood flow to the bleeding site, stopping the hemorrhage. Surgical intervention is typically reserved for larger, expanding, or symptomatic hematomas, especially if there are signs of active bleeding or rupture. Surgical options range from draining the hematoma to more extensive procedures like hepatic resection in severe cases.
Potential Complications and Prognosis
Liver hematomas can lead to several complications, with the most serious being rupture. If a hematoma ruptures, it can cause severe internal bleeding and hypovolemic shock, a life-threatening condition where the body loses a large amount of blood. Infection within the hematoma is another possible complication, necessitating drainage and antibiotic treatment.
The hematoma can also compress surrounding liver tissue, potentially impairing liver function. Prognosis is influenced by the hematoma’s size, its underlying cause, and the timeliness of medical intervention. While many small hematomas heal without long-term issues, severe cases, particularly those involving rupture, carry a higher risk and require immediate and skilled medical attention.