Streptokinase-induced subcapsular hematoma of the liver

Complications with thrombolytic therapy have been shown to occur no more frequently than with conventional anticoagulant therapy. Hemorrhagic complications and allergic skin reactions are the most frequently encountered adverse effects. The vast majority of the associated bleeding complications have been related to invasive procedure and monitoring techniques. The administration of systemic streptokinase was complicated in one case by development of progressive abdominal pain and hypotension necessitating an emergency exploratory laparotomy. A ruptured subcapsular hematoma of the left lobe of the liver was found and successfully repaired. This case of visceral hemorrhage complicating streptokinase therapy was not related to previous abdominal trauma or invasive procedure.