Hepatic Subcapsular Hematoma with Different Clinical Features in Two Neonates

The liver of a newborn is vulnerable to damage during the process of delivery or on external manipulation. Although hepatic subcapsular hematoma occurs relatively commonly in the perinatal period, it is clinically unnoticeable in the majority of the cases. We report two cases of hepatic subcapsular hematoma in neonates who presented with different clinical features. The first newborn was a macrosomic full-term infant. He presented with severe hyperbilirubinemia, requiring intensive phototherapy and exchange transfusion twice within 8 days of life. In contrast, the other baby was a very low-birth-weight preterm infant, resuscitated with endotracheal intubation and chest compression due to asphyxia. He presented with severe pallor, uncontrolled bleeding tendency, and hemorrhagic shock which suddenly lead to catastrophic result. Identifying the high-risk patients and various clinical characteristics is crucial for the early detection and proper management of hepatic subcapsular hematoma in newborns.