Massive subcapsular hepatic hematoma post-drainage of hepatic abscess: a case in favor of conservative management
DOI:
https://doi.org/10.62059/gfn66577Keywords:
Hematoma, Liver abscess, Drainage, Klebsiella pneumoniae, Coagulopathy, ThromboelastographyAbstract
Pyogenic liver abscess (PLA) caused by Klebsiella pneumoniae in diabetic patients has high morbidity and mortality (case fatality rate 3-30%). We present the case of a 57-year-old male patient with decompensated type 2 diabetes mellitus (HbA1c 10.1%) who developed a 60 cc PLA in segments V and VI, complicated by septic shock, diabetic ketoacidosis, and a massive subcapsular hepatic hematoma (30% of liver volume) following percutaneous drainage. Thromboelastography showed platelet dysfunction and dysfibrinogenemia, guiding conservative management with correction of coagulopathy. Blood cultures and drainage culture were positive for K. pneumoniae sensitive to amoxicillin/sulbactam. The patient recovered favorably after 6 days in the intensive care unit and was discharged from the hospital after 14 days. This case highlights the importance of multidisciplinary management, the use of thromboelastography for coagulopathy in sepsis, and that conservative management of hepatic subcapsular hematoma is effective in hemodynamically stabilized patients.
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Copyright (c) 2026 Miriam Kapa Ticona (Autor/a)
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