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Traumatic rupture of the left lobe of the liver and rupture of the left diaphragm with left chylothorax

Authors
Journal
The American Journal of Surgery
0002-9610
Publisher
Elsevier
Publication Date
Volume
51
Issue
2
Identifiers
DOI: 10.1016/s0002-9610(41)90162-9
Disciplines
  • Communication

Abstract

Abstract Reports of traumatic ruptures of the liver are not common and this case is most unusual, in that the original injury was a true rupture of the left lobe of the liver and rupture of the left diaphragm. The bile leaked down into the lesser omental sac as well as into the left chest. The bile and exudate continued to collect in the lesser omental sac, forming a large tumor mass in the upper abdomen. The patient was discharged from the hospital on the one hundred fourteenth day and had apparently recovered. He was readmitted thirty-nine days later and died from operative shock during an exploratory laparotomy. At autopsy an acute splenitis was found. The spleen was displaced from the splenic fossa and adhered to the inferior surface of the atrophied left lobe of the liver. There was a direct communication between the left pleural cavity and lesser omental sac by a tunnel passing through the diaphragm and the atrophied left lobe of the liver. I have been unable to find a similar case report in the available literature. The roentgenograms were taken and interpreted by G. W. Murphy, m.d. There was a series of thirteen films but it was not possible to include all in this report, for the lack of space. The majority of the films were taken with a portable machine. The autopsy and the microscopic tissue examinations were performed by Alfred Blumberg, m.d..

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