A rare case of hepatic subcapsular hematoma presenting with severe anemia in a 20-hour old term newborn: case report

Abstract

Hepatic subcapsular hematoma is an extremely rare clinical condition in the neonatal period. Being a life-threatening emergency, it requires prompt diagnosis and management. In a newborn presented with severe anemia, hypovolemic shock, and abdominal distention with hemoperitoneum without any identifiable risk factors hepatic subcapsular hematoma should be considered. Newborns may develop catastrophic acute and long-term complications if the diagnosis is not made timely. Obstetricians, pediatricians, neonatologists and pediatric surgeons should have a high of the index of suspicion of hepatic subcapsular hematoma in newborns to avoid delay in the diagnosis and to reduce neonatal morbidity and mortality.

Here, we report a 20 hour’s old male term newborn diagnosed with Hepatic Subcapsular Hematoma after he presented with progressive abdominal distension and severe anemia. Abdominal ultra-sound showed a well-defined round heterogenic echogenic liver mass and massive intra-peritoneal fluid collection. The newborn was managed in the Neonatal Intensive Care Unit with Fresh Frozen Plasma transfusion, Whole blood transfusion and vitamin K administration, and discharged im-proved after a week. A high index of clinical suspicion is necessary to avoid delayed diagnosis and life-threatening complications among health professionals in the neonatal intensive care unit.