Case contribution: Dr Radhiana Hassan
- A 13 years old boy
- Motorcycle skidded
- Vital signs stable
- Complaint of vague pain at abdomen
CT scan findings:
- Multiple short lacerations in left lobe of liver (red arrows)
- These lacerations do not extend to capsular surface
- A short laceration near the hilum (yellow arrow) less than one cm
- No intraparenchymal hematoma, no free fluid seen
Progress of patient:
- Patient was managed conservatively for the liver injury
- However he had prolong admission due to multiple injuries:
- open fracture right tibia and fibula with external fixator complicated with osteomyelitis
- Closed fracture of midshaft femur, plating done
- Post linsfrac amputation and SSG of right foot
Diagnosis: Grade I liver injury
- The liver is the largest solid abdominal organ with a relatively fixed position is prone to injury.
- The liver is the second most commonly injured organ in abdominal trauma.
- CT has high sensitivity and specificity for the detection of liver injury.
- The CT features of blunt liver injuries are lacerations, subcapsular and parenchymal haematomas, active haemorrhage and vascular injuries.
- Grade I liver injury according to AAST liver injury grading system refers to subcapsular hematoma of <10% surface area or laceration with capsular tear <1 cm in parenchymal