# Intrahepatic subcapsular hematoma after laparoscopic cholecystectomy in a male patient: a case report

## TL;DR

A 41-year-old man developed a rare liver hematoma after a routine gallbladder surgery, highlighting the need for careful post-operative monitoring.

## Contribution

This case report documents a rare complication of intrahepatic subcapsular hematoma following laparoscopic cholecystectomy.

## Key findings

- The patient developed a subcapsular hepatic and intraparenchymal hematoma two days after surgery.
- Conservative management with fluid resuscitation and blood transfusion led to stabilization and recovery.
- The case underscores the importance of monitoring for rare post-operative complications like ISH.

## Abstract

A 41-year-old male, with a clear medical background, underwent laparoscopic cholecystectomy for uncomplicated acute cholecystitis. No complications were observed intraoperatively. Second day after operation, the patient developed intense right upper quadrant pain, dizziness, and hypotension with a hemoglobin drop to 8.8 g/dl. Subsequently, an urgent computed tomography was done, which identified subcapsular hepatic with an intraparenchymal hematoma, and therefore, the diagnosis of intrahepatic subcapsular hematoma (ISH) was made. After fluid resuscitation and blood transfusion, the hemodynamic status became stable with no further hemoglobin decline noted. Further serial imaging was conducted and showed no signs of expansion nor intra-abdominal hemorrhage and the conservative line of management was carried on. Nine days later, the patient was discharged home. This report emphasizes the importance of close monitoring of patients who undergo LC and the possibility of ISH, although being rare, in those who report acute abdominal pain and hemodynamic instability after LC.