Tennessee Medicine E-Journal


The Liver is a highly vascular organ that is vulnerable to traumatic injury because of its size and fixed position in the right hypochondrium. Hepatic laceration is often a fatal complication of trauma, pregnancy, anticoagulant therapy, connective tissue disorders, liver infiltrative diseases, hepatocellular carcinomas. Patients usually present with severe right upper quadrant pain, abdominal distention, guarding, acute anemia or hypotension. Suspicion of injury is raised from presentation, physical examination and laboratory findings. CT abdomen usually confirms the injury and defines injury grade. Biliary tree disruption is a frequent complication of non-operative management; diagnosis and evaluation of the leak site may be made by ERCP and HIDA scan. Drainage of the bile collection followed by close observation serves as definitive therapy. Hepatic laceration, though life-threatening, is not a well-described complication of cough. Our report provides a detailed description of such a case.