title: 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.
authors.affiliation: Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston Houston, USA.
authors.forename: Susanna C
authors.initials: SC
authors.lastname: Spence
authors.affiliation: Department of Pediatrics, Division of Critical Care, University of Texas Health Science Center at Houston Houston, USA.
authors.forename: Nathaniel H P
authors.initials: NH
authors.lastname: Strobel
authors.affiliation: Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston Houston, USA.
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Beckmann
authors.affiliation: Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston Houston, USA.
authors.forename: Manickam
authors.initials: M
authors.lastname: Kumaravel
mesh_terms: D001929:Brain Edema / Q000000981:diagnostic imaging / Q000209:etiology; D002648:Child; D004677:Encephalocele / Q000000981:diagnostic imaging / Q000209:etiology; D017809:Fatal Outcome; D006501:Hepatic Encephalopathy / Q000209:etiology; D006801:Humans; D022124:Hyperammonemia / Q000209:etiology; D008099:Liver / Q000293:injuries*; D008297:Male; D011169:Portal Vein; D012253:Rib Fractures / Q000150:complications; D014057:Tomography, X-Ray Computed; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000209:etiology*; D014682:Vena Cava, Inferior; D014949:Wounds, Nonpenetrating / Q000150:complications*
keywords: High grade liver injury; grade V liver laceration; traumatic portacaval fistula; traumatic portosystemic fistula; traumatic portosystemic shunt