Citation Information :
da Fonseca Neto OC, Moutinho LE, Costa LR. Early Traumatic Hepatothorax: An Underdiagnose Complication of High Energy Blunt Trauma. Panam J Trauma Crit Care Emerg Surg 2021; 10 (2):82-84.
Aim and objective: This paper reports a case of early traumatic hepatothorax and discusses diagnosis and treatment according to an updated literature review.
Background: Hepatothorax is the abnormal displacement of the liver to the chest. It is a rare condition, which may be challenging to diagnose, and is associated with high energy blunt trauma. Hepatothorax may evolve in different phases: initial, latent, and obstructive; and lead to significant complications and death.
Case description: This paper reports the case of a female patient, 35-year-old, diagnosed with hepatothorax due to a car crash causing a high-energy thoracoabdominal trauma. Due to poor clinical progress after chest drainage, a subsequent helical computerized tomography was done and diagnosed a right diaphragmatic injury and hepatic herniation to the chest. The patient underwent early surgical correction of the diaphragmatic injury and she was later successfully discharged home without complications after a 1-year follow-up.
Conclusion: The literature reports numerous underdiagnosed cases and later surgical correction of traumatic hepatothorax. In this case, persistent dyspnea, despite chest drainage, following a high-energy trauma led to the search and identification of the hepatothorax.
Clinical significance: Physicians should have a high index of suspicion for traumatic hepatothorax in high-energy blunt thoracoabdominal trauma and consider early surgical repair, which is associated with lower morbidity and mortality in this type of injury.
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