Hepatic injury is a common sequela to blunt abdominal trauma and presents a diagnostic and therapeutic challenge. Although early abdominal exploration usually is recommended when hepatic injury is suspected, a few patients will experience subcapsular hematoma without laceration. Surgical management of such patients is less clearly defined. The present report summarizes the experience at the UCLA Hospital with four patients who sustained subcapsular hematomas of the liver after blunt trauma. Each patient was managed by careful observation, sedation, and nasogastric decompression, with gradual resolution of the hematoma as seen on serial liver scans. In selected patients with subcapsular hematoma of the liver, nonoperative management may be desirable.
Richie JP, Fonkalsrud EW. Subcapsular Hematoma of the LiverNonoperative Management. Arch Surg. 1972;104(6):781-784. doi:10.1001/archsurg.1972.04180060031007