Liver injury associated with massive hemoperitoneum secondary to trauma, case report

Abstract

Case description: 23-year-old patient with abdominal hemorrhage of unclear origin, who subsequently presented hemodynamic instability, requiring surgical management on three occasions with satisfactory evolution.

Clinical findings: she presented quantified bleeding of 5500 cc in the abdominal cavity (grade IV-ATLS classification) with liver lesions in segments I, IV and VIII, without findings suggestive of trauma on physical examination, or other internal traumatic findings.

Treatment and results: An early surgical intervention was carried out through exploratory laparotomy with findings already described, in addition to two additional surgical procedures that led to control of bleeding, with satisfactory evolution.

Clinical relevance: Abdominal bleeding and solid viscus laceration secondary to blunt abdominal trauma is a common etiology in young male patients, contrary to this statement, bleeding of hepatic origin without trauma is a rare etiology. The present case turns out to be a diagnostic difficulty in terms of etiology, since what was evidenced in the surgical exploration does not agree with the external physical examination, without a clear clinical history at admission, the question of the cause is left.