PMC4573864_01
CT scan showing grade 4 multiple liver lacerations.
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Urgent exploratory laparotomy revealed grade IV multiple liver lacerations (Fig. 1A). predominantly in segments VII/VIII with active oozing, colonic hepatic flexure seromuscular tear, proximal transverse colonic contusion and hematoma extending to the peripancreatic and duodenal areas. A follow-up CT scan was performed 1 week post operatively and revealed a collection around the liver (Fig. 1A).
(A) MRCP showing a biloma with no intra or extra hepatic biliary radicles injuries, (B) CT showing drain insertion at the biloma site.
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It showed a biloma with no intra or extra hepatic biliary radicles injuries (Fig. 2A). A CT guided aspiration was done with a drain insertion at the biloma site (Fig. 2B).
CBD stent in-place.
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Therefore, CBD stenting was deployed (Fig. 3A and B).
Follow up CT abdomen showing resolution of the bile collection.
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CT scan showed resolution of the collection (Fig. 4). CBD stent was removed safely with unevental hospital course and he was discharged home after 1 month of admission with complete recovery.