Spontaneous bilobar subcapsular hematoma of the liver while undergoing anticoagulation therapy: our experience and review of the literature.

We report on a case of bilateral subcapsular hematoma of the liver, occurring during treatment with warfarin. A 64-year-old woman was put on long-term warfarin therapy. After a bout of severe right hypochondriac pain, computed tomography (CT) scan showed subcapsular hematoma of the liver. Subsequent CT scan, conservative policy only, showed regression of the hematoma. The patient was discharged from the hospital on the 23rd day. We conclude that a nonruptured spontaneous liver hematoma should not be surgically removed. A conservative management with close observation is the mainstay therapy. A switch from warfarin therapy to another anticoagulation therapy is strongly suggested.