Spontaneous Subcapsular Hematoma of the Liver in a Patient on Maintenance Hemodialysis

Spontaneous bleeding in various parts of the body has been reported in patients receiving maintenance hemodialysis, but reports on spontaneous subcapsular hematoma of the liver are scarce. We present a case of spontaneous subcapsular hematoma of the liver which developed in a 53-year-old man with maintenance hemodialysis. He was admitted to our hospital with epigastric pain and abnormal liver function test. On abdominal computed tomographic (CT) scan, a large, well-defined subcapsular mass of the liver with a density consistent with blood was observed. We performed embolization of the bleeding vessel and percutaneous drainage of the hematoma. Five months later, follow up abdominal CT scan revealed a moderate reduction of the subcapsular hematoma. In conclusion, the possibility of spontaneous hematoma of the liver should be considered in hemodialysis patients with epigastric pain, unexplained anemia and abnormal liver function.