SUBCAPSULAR HEMATOMA AFTER LAPAROSCOPIC CHOLECYSTECTOMY, ASSOCIATED WITH KETOROLAC ADMINISTRATION

Ketorolac is the first injectable nonsteroidal antiinflammatory drug u sed as an analgesic in the perioperative period. Its adverse effect pr ofile is different from that of the opioid analgesics; in particular, in its lack of respiratory depressive actions. However, ketorolac has risks associated with its perioperative administration, including epis odes of substantial gastrointestinal bleeding. A patient undergoing el ective laparoscopic cholecystectomy developed a subcapsular hepatic he matoma shortly after receiving a dose of injectable ketorolac. No evid ence of parenchymal injury was found on laparoscopy, which argues agai nst iatrogenic trauma. Clinicians should be aware that ketorolac may c ause or aggravate bleeding, and it should be used with caution in peri operative patients.