PMC2852596_01
(a) CT scan demonstrating extensive intraparenchymal hematoma and compression of portal vein (PV) branches; (b) for comparison, a CT scan from the same patient from 2 years prior shows the normal appearance of a right lobe graft with normal portal vein branches.
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In addition, there was a hypodense region within segment 8 in a subcapsular distribution which was felt to also represent hemorrhage or an area of infarction of the liver (Figure 1).
Hepatic arteriogram demonstrating medial displacement of hepatic arterioles due to mass effect of hematoma and lack of any arterial bleeding site.
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Selective angiograms in the anterior and posterior branches of the right hepatic artery failed to show any active bleeding or pseudoaneurysm (Figure 2).
Gross photo of explanted liver demonstrating large area of hemorrhage and necrosis.
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Explant demonstrated hemorrhage and adhesions of the serosa, multiple areas of ischemic necrosis occupying greater than 90% of the parenchyma, focal acute parenchymal hemorrhage, and central hematoma (Figures 3 and 4).
Photomicrograph of explanted liver demonstrating massive necrosis and architectural collapse.
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Explant demonstrated hemorrhage and adhesions of the serosa, multiple areas of ischemic necrosis occupying greater than 90% of the parenchyma, focal acute parenchymal hemorrhage, and central hematoma (Figures 3 and 4).