Patterns of liver injury in childhood: CT analysis

Abstract

Forty-eight consecutive cases of liver injury diagnosed by CT in hemodynamically stable children were analyzed retrospectively for anatomic location, type of injury, associated nonhepatic injuries, and complications. It was found that the right lobe was involved in 83% of all injuries, and that the posterior segment of the right lobe was injured most often. Right-sided injuries were usually superficial and simple, while leftsided injuries were more likely to be deep and complex. Significant complications were associated with deep, complex, perihilar injuries. Retroperitoneal blood collections were noted around the adrenal, in a distribution not previously described.

Hepatic parenchymal and subcapsular gas after hepatic laceration caused by blunt abdominal trauma

“…In an earlier large series of children who had CT scans made after blunt abdominal trauma and liver injury, intrahepatic gas was not identified [3]. In only two prior cases, one on plain films [4] and one on CT scan [5], has posttraumatic intrahepatic gas been found in the absence of infection.…”

Imaging Children with Abdominal Trauma

“…Splenic injuries occur in nearly one third of patients with hepatic injury. Most hepatic injury occurs in the posterior segment of the right lobe [20]. The effects of blunt force are maximized in this location because the posterior right lobe is fixed by the coronary ligaments, which limits its movement while the rest of the liver is free to move.…”

Isolated injury of the caudate lobe of the liver due to cardiopulmonary resuscitation

“…Isolated hepatic caudate lobe injury, as in this case, has thus far been reported only in association with trauma [4–7]. In itself, hepatic caudate lobe injury is extremely rare and more commonly occurs in association with multilobar hepatic trauma [25, 26]. To the best of our knowledge, no report of isolated hepatic caudate lobe injury has yet been made in association with CPR.…”