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

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.