Liver laceration: AAST grade V

Case contributed by RMH Core Conditions


Motor vehicle collision.

Patient Data

Age: 28
Gender: Male

No aortic injury. The pericardium is content of normal appearances. No pneumothorax or hemothorax. 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 hemoperitoneum. Hemorrhage 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-embolization with particles, which was effective and hemostasis was achieved. 

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Case information

rID: 34215
Published: 10th Feb 2015
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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