Liver laceration - grade IV

Case contributed by Dr Ian Bickle

Presentation

This male in his 30's was involved in an industrial accident. Patient scanned promptly after arrival in A & E.

Patient Data

Age: 35 years
Gender: Male
Modality: CT

Large laceration in the right lobe of the liver with a perihepatic haematoma. 

Active contrast extravastation from the liver parenchyma into the perihepatic space

Case Discussion

 Contrast enhanced CT (be it single or multiphase) is the imaging modality of choice in the assessment of blunt trauma to the abdomen. Splenic and liver injuries are most common.

Clinical classication systems, such as that by the American Association for the Surgery of Trauma, have been developed, in which CT plays an important role.

This has a classification from I - VI, which ranges from a small parenchymal tear and subcapsular haematoma (I) through to hepatic avulsion (VI).

In Grade IV, the laceration causes disruption to 25-75% of a hepatic lobe or 1-3 Couinaud segments within a single lobe.

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Case Information

rID: 19226
Case created: 18th Aug 2012
Last edited: 10th Dec 2016
Inclusion in quiz mode: Included

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