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Medical Science Monitor Basic Research


Massive Rhabdomyolysis; A Rare Cause of Hepatocellular Dysfunction

Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Clinical situation which can not be reproduced for ethical reasons

Abdel Rahman A. Al Manasra, Osama K. Shattarah

Jordan Department of General Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan

Am J Case Rep 2018; 19:105-108

DOI: 10.12659/AJCR.906452

Available online:

Published: 2018-01-29

BACKGROUND: Rhabdomyolysis syndrome is a rare surgical complication. It is infrequently reported in prolonged operations under lateral decubitus position. This syndrome mainly impacts kidney function and electrolytes levels; liver is another organ that is uncommonly affected.
CASE REPORT: A 54-year-old male underwent a partial hepatectomy in the supine position, the procedure lasted three hours. After five days of uneventful recovery from surgery, he was readmitted to the hospital with rhabdomyolysis syndrome involving his lower limbs. No predisposing factors other than surgery could be identified. Based on blood tests, the only affected organ was the liver. Upon aggressive hydration, the creatinine kinase, hepatic enzymes, bilirubin levels, and prothrombin time were normalized. The patient regained normal physical strength over the next few weeks.
CONCLUSIONS: Liver dysfunction secondary to rhabdomyolysis is rare but should be considered when other causes are excluded. Prothrombin time, bilirubin levels and albumin levels may help to identify concomitant liver damage. Rhabdomyolysis is rarely reported in liver resection surgeries.

Keywords: Hepatectomy, Liver Diseases, rhabdomyolysis