Liver injury and complications in the postoperative trauma patient: CT evaluation

Twenty-eight patients with surgically documented and classified hepatic injury were studied by computed tomography (CT) in the postoperative period. CT demonstrated no abnormalities in 12 of these patients, most of whom had sustained simple lacerations of the liver. Of the 16 patients with abnormal scans, perihepatic fluid collections were present in six, five of whom had simple lacerations at surgery. The other 10 patients had CT evidence of parenchymal abnormalities, and all of these had sustained major hepatic injuries. CT is useful in depicting the postoperative anatomy, and in many cases demonstrates the nature and extent of damage; the likelihood of finding an abnormality varies with the severity of the injury, even though repair has been attempted. The frequent problem of postoperative sepsis is also amenable to CT evaluation, but the changes demonstrated are often nonspecific and the possibility of residual hepatic injury has to be considered. Finally, CT can document healing of parenchymal injury.