Hepatic subcapsular hematoma after extracorporeal shock wave lithotripsy (ESWL) for pancreatic stones

We present a patient with complication of huge hepatic subcapsular hematoma after extracorporeal shock wave lithotripsy (ESWL) for pancreatic lithotri psy. The hematoma measured 78-110 mm. Angiography showed a subcapsular hema toma, rather than a hematoma in the liver. In the arterial phase, the dista l end of the small vessel showed spotty opacification similar to microaneur ysma, suggesting that it was an injury caused by separation of the liver an d its capsule, caused by the shock waves. The portal vein and hepatic vein were normal. After 8 weeks of conservative therapy, the hematoma was gradua lly absorbed and the patient was discharged. Eight months after the acciden t, the hematoma had decreased to 40 mm in size. After 20 months, it was com pletely absorbed. The reported rate of renal subcapsular hematoma after ESW L for renal or ureter stones is 0.1%-0.7%. To date, however, only five case s of hepatic subcapsular hematoma after right renal stone disintegration ha ve been reported. This is the first report of hepatic subcapsular hematoma after ESWL for pancreatic stones.