A case of liver injury finally required left hepatectomy due to bile fistula after nonoperative management with trans-catheter arterial embolization.

Abstract

A man in his forties was admitted to the hospital with severe abdominal pain after being struck by an aluminum block. The patient was hemodynamically stable, and enhanced computed tomography scans revealed a liver injury of grade 4. Nonoperative management with trans-catheter arterial embolization was performed and hemostasis was achieved. However, biliary complications, liver necrosis and liver abscess were observed. A planed left lobectomy was performed, and the patient fully recovered. Careful monitoring for complications is necessary in the course of nonoperative management of high-grade liver injury so that early treatment can be provided.