A case of rupture of voluminous spontaneous subcapsular hematoma of the liver in Bamako

Rupture of spontaneous subcapsular hematoma of the liver is very rare and therefore it has been rarely described in the literature. It generally occurs among women with underlying liver disease or often, during pregnancy, in women with HELLP syndrome. We here report the case of a 60-year old man with no particular past medical history presenting with large subcapsular haematoma of the liver. He was admitted to the Emergency Department with moderate-intensity right hypochondre pain evolving over the last week, which was aggravated, two days before, by influenza-like illness associating cough, yellowish sputum and sweatings. Clinical examination showed abdominal tenderness on palpation of the right hypochondre and hypogastrium. The remainder of the clinic examination was normal. Laboratory tests showed hemoglobin level 7.8g/dl, MCV: 79.9, reticulocyte count 48.9. computed tomography (CT) scan showed voluminous subcapsular hematoma of the liver measuring 17cm in height, 14cm in cross-sectional diameter and 5cm in thickness and a hepatic nodule measuring 10mm (A) with hemoperitoine of great abundance without active bleeding (B). The patient underwent visceral surgery (laparotomy) with favorable postoperative outcome.