Sunday, September 23, 2012

CASE: Liver laceration with tare - Emergency left hepatectomy

young female with 6 weeks amenorrhoea and h/o fall from 3rd floor height
and hemoperitoneum
CECT: S/O LIVER left lobe with seg 8 extension hematoma and laceration with moderate free fluid in abdomen
however pt remained hemodynamically stable for 2 days, Hb remained stable around 10 after initial transfusion of two PCV.

Developed distension, fever, sepsis on day 3
repeat CT S/o gross free fluid with increased non enhancing liver paranchyma (on aspiration found to have blood and bile mixed peritonitis)

taken up for surgery and EMERGENCY LEFT HEPATECTOMY with ligation of left hepatic ducts was done (confirmed with intra op cholangiography) along with MTP.
post op pat had minor biliary lieak from paranchyma draining 20 mlbile/day..and was discharged with drain on normal diet on POD 11.