PMC4016783_01
Computed tomography results of the patient. a) presence of a right hemothorax without pulmonary lesions; b) discrete hemoperitoneum by an active bleeding parenchymal liver laceration and "free air" in the abdomen.
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F1
From the scan, the presence of a right hemothorax without pulmonary lesions was seen, with moderate hemoperitoneum from an active bleeding parenchymal liver laceration and subdiaphragmatic air in the abdomen as a bowel perforation (Figure 1).
Characteristics of the stab wound and intra-operative findings. a) bleeding stab wound in the right upper quadrant; b) liver laceration and right diaphragmatic injury; c) application of hemostatic matrix (Floseal ) on liver lesion; d) repair of diaphragmatic lesion with non-absorbables sutures and positioning of medicated sponge containing thrombin and human fibrinogen (Tachosil ).
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F2
After stopping the bleeding from the liver and bile leakage it was decided to adopt a conservative approach applying hemostatic matrix on liver injury (Figure 2).