title: Development of a renal subcapsular hematoma during angiography for diagnosis and subsequent treatment of hepatocellular carcinoma.
abstract: A renal subcapsular hematoma rarely occurs without a history of trauma. It has been reported as a complication of urological interventions and also reported to occur spontaneously in patients with renal malignancies. However, there are no previous reports of renal subcapsular hematomas occurring in connection with abdominal angiography. We report here a case of a renal subcapsular hematoma that developed and was recognized during abdominal angiography for treatment of hepatocellular carcinoma (HCC). An 80-year-old male was referred to our hospital for transarterial embolization for multiple HCCs. His past medical history included hypertension. His laboratory data showed slightly decreased number of platelets and hepaplastin test due to liver cirrhosis. When computed tomography angiography was performed, a 7-cm subcapsular hematoma developed and was recognized over the right kidney during the procedure. He was successfully managed supportively with blood transfusion, tranexamic acid and antibiotics. Since thrombocytopenia and hypertension are reportedly risk factors for hematoma formation, careful manipulation is required during angiography in HCC patients with liver cirrhosis and hypertension. It must be kept in mind that rare complications, such as a renal subcapsular hematoma, can happen during abdominal angiography for diagnostic and interventional treatment of HCC.
authors.affiliation: Department of Gastroenterology and Oncology, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hirao
authors.forename: Testu
authors.initials: T
authors.lastname: Tomonari
authors.forename: Hironori
authors.initials: H
authors.lastname: Tanaka
authors.forename: Kumiko
authors.initials: K
authors.lastname: Tanaka
authors.forename: Miwako
authors.initials: M
authors.lastname: Kagawa
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tanaka
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Taniguchi
authors.forename: Rie
authors.initials: R
authors.lastname: Harada
authors.forename: Momoko
authors.initials: M
authors.lastname: Sato
authors.forename: Naoki
authors.initials: N
authors.lastname: Muguruma
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Takayama
mesh_terms: D000369:Aged, 80 and over; D000792:Angiography / Q000009:adverse effects; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000628:therapy; D004621:Embolization, Therapeutic; D006406:Hematoma / Q000209:etiology*; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male