What abdominal operation has the patient had?
Trauma laparotomy with liver packing.
What liver injury is present?
Large liver laceration/haematoma with active bleeding.
Very large liver haematoma/laceration with evidence of active bleeding from a branch of the right hepatic artery. Further active haemorrhage within liver parenchyma in liver segment VI. Numerous peri-hepatic surgical packs. Free gas in keeping with recent laparotomy (vac dressing noted).
No large pneumothorax. Small left haemothorax. Undisplaced right anterior 5th-7th rib fractures. Displaced left anterior 3rd rib fracture. Undisplaced left anterior 2nd, 4th and 5th rib fractures. Undisplaced transverse sternal body fracture. Extensive right-sided lung consolidation, with complete right upper lobar consolidation. Less extensive left-sided patchy consolidation.