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Complex Liver Injury—a Quagmire to a Trauma Surgeon

  • Harshit AgarwalEmail author
  • Abhinav Kumar
  • Amit Gupta
  • Subodh Kumar
  • Sushma Sagar
  • Biplab Mishra
Case Report
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Abstract

Non-operative management has become a norm in patients with liver trauma and operative management is guided by hemodynamic status. Introduction of haemodynamic status. Introduction of contrast enhanced computed tomography (CECT) abdomen has made NOM possible by helping in exclusion of other injuries and identification of vascular injuries. Haemodynamic instability is now considered as an only absolute indication for operative intervention in liver injuries. However, liver trauma is associated with a large number of complications in the form of perihepatic abscess, hepatic necrosis, bile leak, etc. Patient’s undergoing operative intervention for liver trauma are more at risk for these complications. As such regular dynamic assessment is required for early identification and management of these complications. We present a case of a complex liver injury in a 27-year-old male who underwent operative intervention for liver trauma and had a varied number of liver trauma associated complications, with enterohepatic fistula as one of the rarest associated complications.

Keywords

Enterohepatic fistula Damage control surgery Liver trauma Angioembolisation Haemorrhage 

Abbreviations

NOM

Non-operative management

CECT

Contrast enhance computed tomography

ICU

Intensive care unit

FAST

Focussed assessment with sonography in trauma

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no competing interests.

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Copyright information

© Association of Surgeons of India 2019

Authors and Affiliations

  • Harshit Agarwal
    • 1
    Email author
  • Abhinav Kumar
    • 1
  • Amit Gupta
    • 1
  • Subodh Kumar
    • 1
  • Sushma Sagar
    • 1
  • Biplab Mishra
    • 1
  1. 1.Division of Trauma Surgery & Critical CareJPNATC, AIIMSNew DelhiIndia

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