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<p>Spontaneous hepatic haemorrhage is a rare and potentially fatal condition. This case describes a 78-year-old woman on rivaroxaban who presented with haemodynamic shock due to a spontaneous subcapsular liver haematoma with capsular rupture and pseudoaneurysm formation. Imaging revealed multiple abnormal vessels without a single bleeding point. Transarterial embolisation with Gelfoam was performed, achieving haemostasis without significant hepatic infarction. The patient remained stable post-procedure, with normalisation of liver function tests and no underlying liver neoplasm on follow-up imaging. This case underscores the importance of early diagnosis and multidisciplinary intervention. Temporary embolic agents such as Gelfoam offer effective haemostasis with lower risk of long-term hepatic injury in patients with diffuse microvascular disruption.</p>

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Successful embolisation of a spontaneous diffuse subcapsular liver bleeding in a patient receiving rivaroxaban

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月13日

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  • Darragh K. Waters,
  • Jack Alderson,
  • Douglas Mulholland

摘要

Spontaneous hepatic haemorrhage is a rare and potentially fatal condition. This case describes a 78-year-old woman on rivaroxaban who presented with haemodynamic shock due to a spontaneous subcapsular liver haematoma with capsular rupture and pseudoaneurysm formation. Imaging revealed multiple abnormal vessels without a single bleeding point. Transarterial embolisation with Gelfoam was performed, achieving haemostasis without significant hepatic infarction. The patient remained stable post-procedure, with normalisation of liver function tests and no underlying liver neoplasm on follow-up imaging. This case underscores the importance of early diagnosis and multidisciplinary intervention. Temporary embolic agents such as Gelfoam offer effective haemostasis with lower risk of long-term hepatic injury in patients with diffuse microvascular disruption.