Upper abdomen: CT findings following partial hepatectomy

The appearance on computed tomographic (CT) scans of the upper abdomen after partial hepatectomy is complex. The findings expected at CT should not be confused with those of surgical complications, such as abscess, biloma, or hematoma. The findings on CT scans and the records of 17 patients who had undergone partial hepatectomy for malignancy were reviewed. Operations included wedge resection, left medial and lateral segmentectomies, left lobectomy, right subsegmentectomy, right lobectomy, and extended right lobectomy (trisegmentectomy). When partial hepatectomy had been performed with no complications, findings at CT included a small region of low attenuation at the surgical margin, probably due to transient accumulation of blood and bile; a right pleural effusion; extraluminal gas; shift of abdominal organs; hepatic regeneration; and fat attenuation at the resection margin representing the omental patch placed at surgery. Findings associated with surgical complications--such as abscess, biloma, and hematoma--included large or high-attenuation perihepatic and subphrenic fluid collections that did not conform to the resection margin.