Question:

Which of the following is not described as a common complication of high grade liver injury?
1. Biliary tract complications
2. Liver abscess
3. Abdominal compartment syndrome
4. Traumatic portacaval shunt
5. Bleeding





Answer:

The correct answer for the question "Which of the following is not described as a common complication of high grade liver injury?" is:

4. Traumatic portacaval shunt



Explanation
[The most common complications encountered following high grade liver trauma are biliary-tract complications, bleeding, abdominal compartment syndrome, liver abscess, and liver necrosis [1].] A traumatic portacaval shunt is an extremely rare complication of high grade liver injuries, with this being the second reported case.



From the manuscript:
Traumatic Portacaval Shunt: A Case Report and Literature Review
Radiology Case. 2013 Nov; 7(11):1-6


This article belongs to the GI section.




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From the manuscript

Traumatic Portacaval Shunt: A Case Report and Literature Review

Free full text article: Traumatic Portacaval Shunt:  A Case Report and Literature Review

Abstract
Computed tomography (CT) evaluation of the acute polytrauma patient has become well established as a mainstay of ER triage in hemodynamically stable patients. The radiologist plays a pivotal role in directing management by identifying and appropriately categorizing the severity of a patient`s injuries. High-grade liver injuries have undergone an increasing trend of nonoperative management over the last several decades, with concurrent decrease in mortality. However, we present a case of a patient with a grade V liver laceration, in whom a rare portacaval shunt was also present. In the setting of this rare injury, the radiologist will likely be the first person to recognize and categorize a severe complication, which may indicate the need for a fundamental change in patient management.






References



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2. Kozar RA, Moore JB, Niles SE, Holcomb JB, Moore EE, Cothren CC, Hartwell E, Moore FA. Complications of Nonoperative Management of High-Grade Blunt Hepatic Injuries. J Trauma 2005; 59: 1066-1071
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4. Guzman EA, McCahill LE, Rogers FB. Arterioportal fistulas: introduction of a novel classification with therapeutic implications. J Gastrointest Surg 2006; 10: 543-550
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5. Bosoi CR, Rose CF. Brain edema in acute liver failure and chronic liver disease: Similarities and differences. Neurochem Int 2013 Mar; 62(4): 446-57
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6. Oppermann TE, Corcos AC, Jones LM, Barrette RR, Varcelotti JR. Traumatic Intrahepatic Portosystemic Venous Shunt: A Rare Complication of Grade V Liver Laceration. J Trauma 2007; 63: 1230-1233
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7. Madoff DC, Wallace MJ, Ahrar K, Saxon RR. TIPS-related Hepatic Encephalopathy: Management Options with Novel Endovascular Techniques. Radiographics 2004; 24: 21-36
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8. Gallego C, Miralles M, Marin C, Muyor, P, Gonzalez G, Garcia-Hidalgo, E. Congenital Hepatic Shunts. Radiographics 2004; 24: 755-772
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