Grade V liver laceration

Case contributed by RMH Core Conditions

Presentation

Motor vehicle collision.

Patient Data

Age: 28
Gender: Male
Modality: CT

No aortic injury. The pericardium is content of normal appearances. No pneumothorax or haemothorax. The central airways are patent.

Multiple liver lacerations are detected affecting most of the right liver. The lacerations extends to the hilum. There is active extravasation of contrast seen within segment five of the liver, related to the right anterior branch of the hepatic artery (or portal vein).

The liver lacerations are associated with a moderate amount of haemoperitoneum. Haemorrhage is seen around the right adrenal gland. The left adrenal gland is normal..

The right sixth, seventh, eighth, ninth rib fractured laterally.

Case Discussion

CT Trauma protocols vary from institution to institution but where CTA Thorax is followed by CT Abdomen/Pelvis in portal venous phase, it essentially gives a two-phase study of the upper abdomen, which is very useful in assessing for active bleeding. The upper abdomen should always be carefully examined on CTA Thorax. 

This patient proceeded to angio-embolisation with particles, which was effective and haemostasis was achieved. 

PlayAdd to Share

Case Information

rID: 34215
Case created: 10th Feb 2015
Last edited: 3rd May 2016
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.