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Lucas McCormack, MD; Henrik Petrowsky, MD; Pierre-Alain Clavien, MD, PhD

Arch Surg. 2007;142(4):399.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

A 60-year-old woman presented with a 4-week history of a right gluteal hematoma after a mild trauma associated with asthenia and unspecific upper abdominal symptoms. On physical examination, we observed ecchymoses in the flanks, buttocks, and lower limbs. Although abdominal palpation was normal, an ultrasound revealed a large heterogeneous mass of 10 x 7 cm in the left lateral segment of the liver. A contrast-enhanced computed tomogram showed a peripheral nodular pattern of enhancement with a hypodense center (Figure 1). The hematogram revealed anemia (hematocrit value, 19%; hemoglobin level, 9.9 g/dL) and thrombocytopenia (platelet count, 77x 10³/µL). Coagulation tests showed the following values: fibrinogen, 400 mg/dL (11.8 µmol/L) (reference range, 150-400 mg/dL [4.4-11.8 µmol/L]); fibrin degradation products, 1.5 µg/mL (reference range, <0.5 µg/mL); and thrombin–antithrombin III complexes, 17.4 ng/mL (reference range, <5.0 ng/mL). All other biochemical . . . [Full Text of this Article]

What Is the Diagnosis?

Author Affiliations: Swiss HPB (Hepato-Pancreato-Biliary) Centre, Department of Visceral and Transplantation Surgery, Zurich, University Hospital, Switzerland.

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