Intrahepatic Subcapsular Hematoma Due to Pseudoanevrysm: A Rare Complication of Laparoscopic Cholecystectomy

Abstract

Aims: We report a rare case of intrahepatic subcapsular hematoma (ISH) following laparoscopic cholecystectomy (LC), successfully managed with endovascular embolization, and discuss its clinical implications and treatment options Presentation of Case: A 59-year-old male presented with severe right upper quadrant pain 10 days after an uneventful LC. Clinical examination revealed pallor and tachycardia. Laboratory tests showed significant anemia. A contrast-enhanced CT scan revealed a large right-sided subcapsular liver hematoma measuring 21×10×8 cm with active bleeding from a ruptured pseudoaneurysm in segment VIII. The patient underwent urgent endovascular embolization. Post-procedural care included transfusion and close monitoring. He stabilized without the need for surgical intervention and was discharged uneventfully on the fourth day Discussion: ISH is an uncommon but potentially life-threatening complication of LC. Its presentation is often delayed, and diagnosis requires a high index of suspicion. Management strategies depend on hemodynamic status, size of hematoma, and etiology. Embolization is a minimally invasive and effective treatment option Conclusion: This case emphasizes the importance of early recognition and tailored management of ISH post-LC. It also highlights the role of embolization in avoiding surgical morbidity. Greater awareness of this rare complication can improve outcomes and guide future preventive strategies.