Diagnostic Laparoscopy for a Liver Trauma Patient with Increased Ascites After Hepatic Artery Embolization

Abstract

A 20-years-old woman was taken into the local emergency hospital after being involved in a traffic accident. Her vital signs were unstable at that time, and contrast enhanced computed-tomography (CT) scan revealed liver injury (type ⅢB) as well as subarachnoidal bleeding and mesenteric injury. After transcatheter arterial embolization for the liver, her vital signs stabilized. Intensive management for severe multiple organ injury was still needed, so she was brought to our hospital. Follow-up CT scan on arrival revealed an increased amount of abdominal hemorrhage needing diagnosis for the site of bleeding. We chose to perform a diagnostic laparoscopy because the patient was young and her vital signs were stable on arrival. Right hepatic lobe injury was found, but neither active bleeding nor a bile leakage was observed. The serosal injury on the transverse colon was fixed with a serosa: muscular layer suture. After aspirating the hematoma and inserting drains, the procedure was done. She had a good post-operative course and was eventually transferred back to the original hospital. We report herein on the efficacy of a diagnostic laparoscopy for a liver trauma patient.