What Is A Liver Hematoma?
A liver hematoma usually results from injury or trauma to the liver. A liver hematoma can often be treated conservatively, that is there is no need for surgery or any invasive procedure. In some cases however, a liver hematoma can become an extremely serious, and even a life-threatening condition.
A hematoma is a blood vessel injury where blood has escaped and is collected around the blood vessel, but remaining inside encapsulating tissue. A liver hematoma is in one sense a hemorrhage which has occurred inside the liver, but escaping blood is confined to a small area, and the affected person does not usually suffer severe consequences.
On occasion, fortunately somewhat rarely, if the hematoma is large enough, the tissue containing the blood may rupture, and blood can flow into the peritoneal cavity, the cavity which separates the organs within the abdomen from the abdominal wall. This cavity is a fluid filled cavity, but if a liver hematoma ruptures into the cavity the results can sometimes be disastrous.
In adults, a liver hematoma is usually the result of a blunt blow to the liver, most often resulting from an automobile accident, or from a penetrating wound such as that caused by a bullet or a knife. Blunt trauma is more common in children, as the rib cage is more flexible and the liver is more susceptible to injury form forces of compression.
Conservative Treatment Often Best - A liver hematoma is one of those rare injuries in which doing little or nothing can sometimes be the best treatment. In fact, one statistic shows that when liver damage has occurred, and a patient goes into surgery, blood flow at the point of injury has already ceased nearly 70 percent of the time, and the surgery therefore turns out to have had no therapeutic value. Treatment in most cases consists of bed rest and the doctor monitoring the patient's general condition, ready to act of course should things take a turn for the worse.
A liver hematoma can in some instances be difficult to diagnose, even when it may be fairly large. Ultrasound imaging is somewhat effective in diagnosing a problem, but not always. CT and MRI scans often give a better picture of what has occurred. An accurate diagnosis often is based upon signs of internal bleeding and blood loss, abdominal tenderness, nausea or vomiting by the patient, and perhaps most telling, an elevation of liver enzymes.
When Size Matters - While a liver hematoma is somewhat rare unless the liver actually suffers injury from an outside source, the liver is generally considered the abdominal organ to be most prone to injury. This is due in large part to the fact that the liver is the largest of the abdominal organs, hence is a bigger "target" for penetrating wounds, and can also be damaged if compressed against the ribcage, the spine, or the rear abdominal wall. The ligaments attaching the liver to the diaphragm and the abdominal wall can also cause damage to the liver through shear forces in the event of violent movements and pressures on the abdomen. This is often the case in automobile accidents, where ultra rapid deceleration forces act to try and tear the liver from its supportive ligaments and tissues. It was mentioned before that automobile accidents are a major cause of liver hematomas in adults. In recent years, mountain biking accidents have lead to an increasing number of these injuries.
In summary, a liver hematoma involves a burst blood vessel, or leakage from a blood vessel, and is usually not as bad as it sounds, as long as significant amounts of blood do not enter into the abdominal cavity. Treatment is usually conservative and non-invasive, unless circumstances dictate otherwise.