Role of postoperative computed tomography in patients with severe liver injury.
BACKGROUND
The role of postoperative computed tomography (CT) in asymptomatic patients with severe liver injury has not been investigated. The aim of the present study was to investigate the nature and incidence of significant liver-related abnormalities detected by postoperative CT in asymptomatic patients with severe liver injury.


METHODS
This was a prospective study of survivors with severe liver injury (grades III-V) who were treated surgically. The patients underwent CT to evaluate the liver after operation, irrespective of symptoms.


RESULTS
During the study interval there were 181 patients with severe liver injury, of whom 49 fulfilled the criteria for inclusion. The overall incidence of liver-related complications detected by CT was 49 per cent (necrotic areas in the liver in seven patients, seven bilomas, four abscesses, three perihepatic collections and three false aneurysms). In the subgroup of 17 asymptomatic patients CT revealed four abnormalities: two large bilomas, one false aneurysm and one fluid collection. Two of these patients required therapeutic intervention and the other two remained under observation.


CONCLUSIONS
In view of the incidence of asymptomatic significant liver abnormalities following operative management of severe liver injury, it is recommended that these patients undergo routine postoperative CT.
Division of Trauma and Surgical Intensive Care Unit, Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. demetria@usc.edu
D
D
Demetriades
M
M
Karaiskakis
K
K
Alo
G
G
Velmahos
J
J
Murray
J
J
Asensio
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008297:Male; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D013536:Suture Techniques; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000601:surgery; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging / Q000601:surgery