Conservative Management of Major Liver Necrosis after Angioembolization in a Patient with Blunt Trauma

Management of liver injury is challenging particularly for the advanced grades. Increased utility of nonoperative management strategies increases the risk of developing massive liver necrosis (MLN). We reported a case of a 19-year-old male who presented with a history of motor vehicle crash. Abdomin...

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Main Authors:	Abdelrahman, Husham, Ajaj, Ahmad, Atique, Sajid, El-Menyar, Ayman, Al-Thani, Hassan
Format:	Online
Language:	English
Published:	Hindawi Publishing Corporation 2013
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3888687/

id	pubmed-3888687
recordtype	oai_dc
spelling	pubmed-38886872014-01-22 Conservative Management of Major Liver Necrosis after Angioembolization in a Patient with Blunt Trauma Abdelrahman, Husham Ajaj, Ahmad Atique, Sajid El-Menyar, Ayman Al-Thani, Hassan Case Report Management of liver injury is challenging particularly for the advanced grades. Increased utility of nonoperative management strategies increases the risk of developing massive liver necrosis (MLN). We reported a case of a 19-year-old male who presented with a history of motor vehicle crash. Abdominal computerized tomography (CT) scan revealed large liver laceration (Grade 4) with blush and moderate free hemoperitoneum in 3 quadrants. Patient was managed nonoperatively by angioembolization. Two anomalies in hepatic arteries origin were reported and both vessels were selectively cannulated and bilateral gel foam embolization was achieved successfully. The patient developed MLN which was successfully treated conservatively. The follow-up CT showed progressive resolution of necrotic areas with fluid replacement and showed remarkable regeneration of liver tissues. We assume that patients with high-grade liver injuries could be managed successfully with a carefully designed protocol. Special attention should be given to the potential major associated complications. A tailored multidisciplinary approach to manage the subsequent complications would represent the best recommended strategy for favorable outcomes. Hindawi Publishing Corporation 2013 2013-12-29 /pmc/articles/PMC3888687/ /pubmed/24455392 http://dx.doi.org/10.1155/2013/954050 Text en Copyright © 2013 Husham Abdelrahman et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Abdelrahman, Husham Ajaj, Ahmad Atique, Sajid El-Menyar, Ayman Al-Thani, Hassan
spellingShingle	Abdelrahman, Husham Ajaj, Ahmad Atique, Sajid El-Menyar, Ayman Al-Thani, Hassan Conservative Management of Major Liver Necrosis after Angioembolization in a Patient with Blunt Trauma
author_facet	Abdelrahman, Husham Ajaj, Ahmad Atique, Sajid El-Menyar, Ayman Al-Thani, Hassan
author_sort	Abdelrahman, Husham
title	Conservative Management of Major Liver Necrosis after Angioembolization in a Patient with Blunt Trauma
title_short	Conservative Management of Major Liver Necrosis after Angioembolization in a Patient with Blunt Trauma
title_full	Conservative Management of Major Liver Necrosis after Angioembolization in a Patient with Blunt Trauma
title_fullStr	Conservative Management of Major Liver Necrosis after Angioembolization in a Patient with Blunt Trauma
title_full_unstemmed	Conservative Management of Major Liver Necrosis after Angioembolization in a Patient with Blunt Trauma
title_sort	conservative management of major liver necrosis after angioembolization in a patient with blunt trauma
description	Management of liver injury is challenging particularly for the advanced grades. Increased utility of nonoperative management strategies increases the risk of developing massive liver necrosis (MLN). We reported a case of a 19-year-old male who presented with a history of motor vehicle crash. Abdominal computerized tomography (CT) scan revealed large liver laceration (Grade 4) with blush and moderate free hemoperitoneum in 3 quadrants. Patient was managed nonoperatively by angioembolization. Two anomalies in hepatic arteries origin were reported and both vessels were selectively cannulated and bilateral gel foam embolization was achieved successfully. The patient developed MLN which was successfully treated conservatively. The follow-up CT showed progressive resolution of necrotic areas with fluid replacement and showed remarkable regeneration of liver tissues. We assume that patients with high-grade liver injuries could be managed successfully with a carefully designed protocol. Special attention should be given to the potential major associated complications. A tailored multidisciplinary approach to manage the subsequent complications would represent the best recommended strategy for favorable outcomes.
publisher	Hindawi Publishing Corporation
publishDate	2013
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3888687/
_version_	1612046611970523136

Conservative Management of Major Liver Necrosis after Angioembolization in a Patient with Blunt Trauma

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