A fatal pulmonary embolus composed of gross liver tissue

A snowmobile accident caused a pulp injury to the liver and tear of the vena cava of a 21-year-old man. Improvement after fluid resuscitation, right hepatic lobectomy and caval repair was followed by sudden hemodynamic collapse and death. Autopsy revealed pulmonary embolism caused by liver tissue. Presumably the pieces of liver entered the vena cava through the tear and travelled to the lung when blood flow improved. The authors believe that this is the first report of fatal pulmonary embolism caused by macroscopic liver tissue.