Omental liver packs

Omental liver packs have been used in the surgical management of traumatic lacerations and hepatic lobectomy. Knowledge of this surgical technique could avoid misinterpretation or confusion of these findings with true postsurgical complications. 

Technique

This technique consists of mobilizing a portion of the omentum and its vascular pedicle into the liver area of disruption.  The pedicle flap of omentum is packed in the disrupted area, with oversewing of the liver edges and placement of appropriate drainage catheters. 

Radiographic features

CT

The omental pack appears as an area of decreased attenuation with regular/irregular borders. In the interior of the packaging following intravenous contrast administration, appear some linear strandings that represent the opacified vessels within the omentum. 

Complications

This technique has a risk of postoperative complications such as abscess, biloma or hematoma ². 

Differential diagnosis

• hepatic abscess
• hepatic hematoma
• biloma