Subcapsular hepatic hematoma with right hepatic vein thrombosis: a complication of shock wave lithotripsy

Abstract

Extracorporeal shock wave lithotripsy (ESWL) is a well-established, safe andeffective therapeutic modality for surgical treatment of urolithiasis. Hematomais a rare complication of ESWL and, when it occurs, typically involves thekidney. We report the case of a 71-year-old woman who developed severe,persistent abdominal pain after ESWL for a 9-mm stone at the ureteropelvicjunction. Post-treatment CT scan demonstrated a 13 × 6–cm subcapsular hepatichematoma. A follow-up CT scan showed expansion of the hematoma and developmentof hepatic vein thrombosis. This finding, along with persistent abdominalpain and rising liver transaminases, led to surgical intervention. The patient’ssymptoms resolved and liver function returned to baseline following liver decompression.