LIVER CLOT is a very rare post operative complication is dental practice such as Extraction, Periodontal surgery, dental Implants, etc. Liver Clot is also known as ‘currant blood clot’ which is a bright jelly like clot formed over the extraction site after 24 hours. It appears as a proliferative mass, red to light brown in color and soft in consistency and pedunculated, which is usually non-tender on palpation. Liver clot is usually up to a few centimeters in size.
Liver Clot is defined as a red, jelly like clot that is rich in hemoglobin from erythrocytes within the clot. It is also called as currant jelly clot.
It is called as Liver Clot due to its appearance which is similar to Liver. The size of the Liver clot varies due to many factors such as underlying health condition. Liver clot is formed due to venous hemorrhage which is slow, oozing dark red blood. The Liver clot consists of Platelets, trapped RBC’s and fibrin due to which it might vary in size mostly till a few centimeters. The size of the Liver Clot is directly related to the amount of time it is exposed to Tissue Factors.
To remove a Liver clot, you can use a High speed suction or curettage it out and then use Saline irrigation to clear the area, later place direct pressure in the area to prevent any further bleeding.
Underlying causes of Liver Clot are – Liver disease, renal insufficiency, fibrinolysis, leukemia, disseminated intravascular coagulopathy, genetic disorder, medications and conditions which involve clotting factor deficiencies.
It is suspected that Venous hemorrhage is the cause of formation of Liver Clot as it may involve deoxygenated blood or slow flow blood resulting in tissue hypoxia. Capillary bleeding is responsible for the blood loss in maxillofacial region while access to jugular system on the venous side will result in a liver clot.
To control excess bleeding, use of vasoconstrictors locally like epinephrine or procoagulants such as thrombin or collagen can be used. Types of Local Hemostatic Agents. In case of Local Hemostatic agents are not working, systemic medication such as Tranexamic acid should be used. In case of Systemic conditions the required medication should be used to control the increase in its size. To control post extraction bleeding the extraction site should be covered with a moist gauze and pressure applied for a few minutes by the patient to make sure bleeding is stopped.
References:
- https://thejcdp.com/doi/JCDP/pdf/10.5005/jcdp-2-2-42
- Liver Clot – A Rare post operative complication after extraction
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