Treatment strategies for chronic expanding hematomas of the thorax

Muramatsu, Takashi; Shimamura, Mie; Furuichi, Motohiko; Ishimoto, Shinichirou; Ohmori, Kazuo; Shiono, Motomi

doi:10.1007/s00595-010-4462-2

Cited by 19 publications

(14 citation statements)

References 13 publications

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“…The ideal treatment for chronic expanding hematoma is complete removal, including the pseudocapsule [7]. In a previous report, follow-up revealed that 2 of 9 chronic expanding hematomas recurred after marginal excision [8]; however, none of our 7 patients experienced recurrence.…”

Section: Discussionmentioning

confidence: 90%

Chronic Expanding Hematoma in the Extremities: A Clinical Problem of Adhesion to the Surrounding Tissues

Sakamoto

Okamoto

Matsuda

2017

BioMed Research International

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Chronic expanding hematoma is characterized by continuous growth of a blood collection. We analyzed the clinical features of 7 patients with chronic expanding hematomas in the extremities, with an average age of 65.6 years. All lesions occurred in the lower extremities, with 4 seen in the thigh and 3 in the knee region. Six patients had subcutaneous hematomas, while 1 was deep-seated in the thigh. The magnetic resonance features of the lesion were compatible with those of a standard hematoma. A low signal intensity on T1- and T2-weighted imaging at the pseudocapsule was also characteristic. Cystic features were seen in 5 of 7 patients. All lesions were resected together with their pseudocapsule. In the subcutaneous lesions, it was necessary to resect adherent fascia, with or without involved skin. In the deep-seated thigh lesion, the common peroneal nerve was completely adherent to the pseudocapsule, a phenomenon from absence of the common peroneal nerve which appeared after resection. Chronic expanding hematomas of the extremities are predominantly located in the subcutaneous tissue of the lower extremity. The surrounding pseudocapsule is adherent to the adjacent tissues, and clinicians must be aware of this, especially when resecting a deep-seated lesion.

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Section: Discussionmentioning

confidence: 90%

Chronic Expanding Hematoma in the Extremities: A Clinical Problem of Adhesion to the Surrounding Tissues

Sakamoto

Okamoto

Matsuda

2017

BioMed Research International

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“…In the current patient, however, although this was a subcapsular hepatic hematoma anatomically, its clinical course and pathology showed that it was a CEH, and TAE was probably unsuccessful because the bleeding was coming from neocapillaries generated by a chronic inflammatory response. Complete surgical resection of the hematoma, including the capsule, is required, and incomplete resection is believed to entail a high risk of recurrence [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Subcapsular hepatic hematoma: a case of chronic expanding hematoma of the liver

et al. 2021

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Background A chronic expanding hematoma (CEH) enlarges as a result of slight bleeding over several months, and the tissue shows a mixture of blood breakdown products, granulation tissue with capillary ingrowth, and inflammatory tissue. This report presents a case of a subcapsular hepatic CEH that was treated with transarterial embolization (TAE) and hepatectomy. Case presentation A 56-year-old man presented with vomiting and right-sided abdominal pain. Plain abdominal computed tomography (CT) showed a high-density area of fluid collection beneath the capsule of the right hepatic lobe, which was diagnosed as a hematoma. From its anatomical position on the CT images, a subcapsular hepatic hematoma was diagnosed. Though conservative therapy was provided, CT-guided percutaneous drainage and TAE were performed due to worsening symptom. Because the patient's abdominal symptoms re-appeared, extended right segmentectomy including the hematoma was performed. In the resected specimen, the hematoma was located beneath the capsule of the right hepatic lobe, and it was displacing the hepatic parenchyma. Microscopic examination showed a thick fibrous capsule around the hematoma, peripheral lymphocyte and plasmacyte invasion, and aggregations of histiocytes containing phagocytosed hemosiderin. Conclusions Anatomically, this was a case of a subcapsular hepatic hematoma, and pathologically it was shown to be a CEH. Complete surgical resection was effective treatment for this CEH.

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“…Ideal treatment for chronic expanding hematoma is complete resection, including resection of the pseudocapsule [10]. However, complete removal is reportedly difficult in patients with thoracic lesions due to abundant neovascularization beneath the pseudocapsule and the presence of fibrous adhesions to the chest wall [11].…”

Section: Discussionmentioning

confidence: 99%

Chronic Expanding Hematoma in the Thigh: A Late Complication 32 Years After Treatment of Synovial Sarcoma: A Case Report

et al. 2019

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Patient: Female, 49Final Diagnosis: Chronic expanding hematomaSymptoms: Thigh swellingMedication: —Clinical Procedure: —Specialty: Orthopedics and TraumatologyObjective:Rare diseaseBackground:Chronic expanding hematoma is characterized by a continuous growing hematoma lesion.Case Report:The present case is of a patient who had undergone resection of synovial sarcoma in the posterior thigh and subsequent intraoperative radiation to the region at the age of 18 years. The patient observed swelling at the surgical site 31 years later at the age of 49 years. Magnetic resonance imaging revealed a growing hematoma with a cystic appearance. Partial resection of the wall and electrocoagulation of bleeding from the remaining wall were performed at the age of 50 years.Conclusions:Chronic expanding hematoma occurred as a late complication of tumor treatment.

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Treatment strategies for chronic expanding hematomas of the thorax

Abstract: Chronic expanding hematoma of the thorax may occur after thoracic surgery and a tuberculosis infection; however, considering the risk of massive bleeding during surgery, the decision to perform surgery should be made with extreme care.

Cited by 19 publications

References 13 publications

Chronic Expanding Hematoma in the Extremities: A Clinical Problem of Adhesion to the Surrounding Tissues

Chronic Expanding Hematoma in the Extremities: A Clinical Problem of Adhesion to the Surrounding Tissues

Subcapsular hepatic hematoma: a case of chronic expanding hematoma of the liver

Chronic Expanding Hematoma in the Thigh: A Late Complication 32 Years After Treatment of Synovial Sarcoma: A Case Report

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