Neonatal hepatic subcapsular haematoma: an analysis of five cases
10.3760/cma.j.cn113903-20241215-00832
- VernacularTitle:新生儿肝包膜下出血5例分析
- Author:
Liejun SHOU
1
;
Hua YUAN
;
Beimeng YU
;
Jiandong CHEN
Author Information
1. 绍兴市妇幼保健院超声科，绍兴 312000
- Publication Type:Journal Article
- Keywords:
Hepatic, subcapsular;
Haematoma;
Ultrasonography, neonatal;
Risk factors
- From:
Chinese Journal of Perinatal Medicine
2025;28(8):670-674
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors and ultrasonographic features of neonatal hepatic subcapsular haematoma (HSH).Methods:A retrospective study was conducted on five neonates diagnosed with HSH at Shaoxing Maternity and Child Health Care Hospital from June 2020 to June 2024. Clinical data, including clinical manifestations, ultrasonographic characteristics, and follow-up outcomes, and the risk factors of HSH were summarized with descriptive statistical analysis.Results:All five cases were very low/extremely low birth weight preterm infants delivered by cesarean section, with a history of birth asphyxia. Case 1 presented with hypovolemic shock postnatally and was incidentally diagnosed with HSH via abdominal ultrasound. Cases 2 and 3 were diagnosed during a routine ultrasound monitoring of the umbilical venous catheter tip position within 3 d after catheterization. Cases 4 and 5 were diagnosed by abdominal ultrasound re-examination following unsuccessful umbilical venous catheterization. Case 1 received no catheterization or external chest compression, while Cases 2, 3, and 5 received external chest compression during resuscitation. Case 2 had a history of difficult cesarean section. Cases 2 to 5 underwent umbilical venous catheterization (failed in Cases 4 and 5). Ultrasonography revealed cystic-dominant echogenicity, presenting as elongated or oval-shaped with well-defined margins, and were accompanied by varying amounts of echogenic bands and dots. Three cases had single lesions and two had multiple lesions. A total of nine hemorrhagic foci were found with four in the right posterior liver lobe, three in the right anterior lobe, and two in the left lobe. No hepatic capsule disruption was observed in any of the five cases. After immobilization, hemostasis, and supportive care, the haematoma in Case 1 completely resolved with calcification at 134 d after birth, while in the remaining four cases, the haematomas resolved completely without calcification between 17 and 62 d after birth.Conclusions:HSH may present without classical symptoms or signs. In neonates with very low/extremely low birth weight presenting hypovolemic shock, HSH should be suspected, particularly in those with perinatal trauma or a history of external chest compression during resuscitation. Abdominal ultrasound is recommended for exclusion if indicated. Ultrasound not only facilitates the diagnosis of HSH, but also enables dynamic monitoring of hematoma progression and resolution.
