An Idiopathic Hepatic Hematoma Presenting in the Neonatal Period

Hepatic hematoma in newborns is an extremely rare condition, usually secondary to birth trauma or a vascular malformation. Clinically, it is often asymptomatic but can lead to serious complications, including internal bleeding and even signs of liver failure. We report an unusual case of intraparenchymal hepatic hematoma of undetermined etiology in a newborn, without associated birth trauma. This is a male newborn, born at term, admitted on the third day of life for respiratory distress associated with pallor of the skin and mucous membranes and abdominal distension with scrotal and inguinal ecchymoses. An abdominal ultrasound was performed, revealing hepatic hematoma. An abdominal CT scan was subsequently performed, showing a heterogeneous, liquefied intrahepatic collection with a hemorrhagic mass and hyperdense infiltrates in the iliac fossae. Hepatic hematoma is a poorly understood condition with potentially extremely serious consequences, particularly because it can occur idiopathically without a known cause. Indeed, given that clinical symptoms are sometimes nonspecific and that laboratory results may only become apparent later, diagnosis relies primarily on ultrasound, and treatment is most often conservative.