Liver laceration and intercostal artery laceration

Case contributed by RMH Core Conditions
Diagnosis certain


Stabbing. Post bilateral ICCs

Patient Data

Age: 45 years
Gender: Male

The liver demonstrates a low attenuation region through segments 7 and 8 consistent with a liver laceration. Associated subcapsular fluid with linear, high attenuation material present consistent with contrast pooling within it, consistent with active hemorrhage.

At the anterior border of the liver, between 6th and 7th ribs, is an area that demonstrates blush on on arterial phase and pooling of contrast on the venous phase and most likely represents an intercostal artery laceration but may also possibly represent hemorrhage related to the liver laceration. The hematoma has developed in this region measuring 25 x 50 mm. Fat is seen to herniated through this region consistent with a knife track. Gas is seen anterior to the liver consistent with gas tracking from the wound. Besides the air adjacent to the liver laceration, which is related to gas tracking from the wound, no other evidence of pneumoperitoneum present to suggest bowel perforation.

Bilateral ICCs are partially imaged with right hemothorax and bibasal consolidation. 

Case Discussion

Particulate emobolisation of the right hepatic artery was subsequently performed. CTA Thorax performed 12 hours later confirmed a slow active bleeding from the intercostal artery. 

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