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Subcapsular Liver Hematomas in a Patient on Chronic Hemodialysis

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▸Requests for reprints should be addressed to Sonia Borra, M.D.; Renal Dialysis Unit, Kingsbrook Jewish Medical Center, 86 East 49th Street; Brooklyn, NY 11203.

Department of Medicine, Kingsbrook Jewish Medical Center; Brooklyn, New York

Ann Intern Med. 1980;93(4):574-575. doi:10.7326/0003-4819-93-4-574
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An increased prevalence of spontaneous bleeding manifestations has been observed in patients on chronic hemodialysis. They have included gastrointestinal bleeding (1), subdural hematomas (2), uremic hemopericardium (3), hemorrhagic pleural effusion (4), and spontaneous retroperitoneal bleeding (5). This case report describes another bleeding manifestation, namely, spontaneous subscapsular hematomas of the liver.

A 62-year-old woman with chronic glomerulonephritis had been maintained on chronic hemodialysis since 2 November 1977. Dialysis was given thrice-weekly basis for 4 hours with

Figure 1. Technetium-99 sulfur colloid liver scan demonstrating a large filling defect in the left lobe (curved arrow) and a smaller filling defect in the right lobe (straight arrow).

the Travenol hollow fiber, model 1200 (Travenol Laboratories, Inc.; Deerfield, Illinois). She received a 1500-unit loading dose of heparin intravenously and afterwards was placed on


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