SUBCAPSULAR rupture of the liver may occur following minimal or indefinite injury. This subject was reviewed by Corriden in 1940. Since that time only a few additional instances of this condition have been described.
Subcapsular rupture is characterized by the development of a hematoma, often quite large, beneath the liver capsule. An interval of days or hours may elapse between the time of injury and the first appearance of symptoms. A history of injury may be entirely lacking, or may be so unremarkable that it is elicited only by diligent interrogation. The hematoma tends to increase in size, often progressing to the point of rupture. Occasionally intra-abdominal hemorrhage is the first evidence of visceral injury.
In the absence of other disease of the liver, subcapsular rupture occurs more frequently in children. Among the explanations which have been offered to account for the greater susceptibility in youth, the following are included: