title: [Most severe liver rupture with hepatic vein avulsion and massive hemobilia].
abstract: A case report of hepatic trauma in a patient with polytrauma. For treatment of a destroying lesion of the right lobe with disruption of the middle hepatic vein right lobectomy was done. Postoperatively an excessive hyperbilirubinaemia occurred because of a closed central contusion of the left lobe with a biliovenous fistula. This diagnosis was achieved by arteriography before a second operation and intraoperative cholangiography using a T tube. Bilhaemia completely disappeared while mild negative pressure was administered to the T tube. Diagnosis and therapy of bilhaemia are discussed.
mesh_terms: D000293:Adolescent; D001646:Bile; D001769:Blood; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006503:Hepatic Veins / Q000293:injuries*; D006801:Humans; D006932:Hyperbilirubinemia / Q000209:etiology; D008099:Liver / Q000293:injuries* / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D012421:Rupture; D014947:Wounds and Injuries / Q000150:complications
vernacular_title: Schwerste Leberruptur mit Lebervenenabriss und massiver Bilhämie.