title: A rare case of subcapsular liver haematoma following laparoscopic cholecystectomy.
abstract: Laparoscopic cholecystectomy is a commonly performed surgical procedure for the treatment of symptomatic cholelithiasis. As with all surgical procedures, it carries risk, with the most commonly reported complications including infection, bile leak and bleeding. One unusual complication is subcapsular liver haematoma, the diagnosis presented here. This is a rare occurrence; only a small number of cases have been reported in the literature and as yet no conclusive cause or management plan has been found. Iatrogenic liver trauma, the use of oral and intravenous non-steroidal anti-inflammatory drugs (NSAIDs) and anticoagulants have all been named as possible contributing factors. Particularly, the use of ketorolac has been associated with four reported cases of subcapsular haematoma following laparoscopic cholecystectomy. The case reported here refutes that hypothesis, as neither NSAIDs nor anticoagulants were used during the treatment of this patient.
authors.affiliation: Department of General Surgery, Antrim Area Hospital, Antrim, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Brown
authors.affiliation: Department of Urology, Craigavon Area Hospital, Craigavon, UK.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Martin
authors.affiliation: Department of General Surgery, Antrim Area Hospital, Antrim, UK.
authors.forename: Damian
authors.initials: D
authors.lastname: Magee
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000925:Anticoagulants / Q000009:adverse effects; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D002769:Cholelithiasis / Q000601:surgery*; D004322:Drainage; D005260:Female; D006406:Hematoma / Q000628:therapy; D006801:Humans; D020910:Ketorolac / Q000009:adverse effects; D008099:Liver / Q000473:pathology*; D008107:Liver Diseases / Q000209:etiology* / Q000628:therapy; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D020910:Ketorolac