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.

Development of subcapsular hematoma in the pelvic kidney during peripheral angioplasty

“…Two case reports demonstrate the development of subcapsular hematoma in the kidney during angiography. [ 7 , 8 ] In both reports, subcapsular hematoma occurred in the normally located kidney. Our study is the first case report describing subcapsular hematoma formation in the pelvic kidney and during peripheral angioplasty.…”