RT Journal
A1 Propper BW, Lundy JB, Tyner RP, Rasmussen TE
T1 IMage of the month—quiz case
JF Archives of Surgery
JO Archives of Surgery
YR 2010
FD November 15
VO 145
IS 11
SP 1125
OP 1125
DO 10.1001/archsurg.2010.244-a
UL http://dx.doi.org/10.1001/archsurg.2010.244-a
AB 
At our institution, the patient had a Glasgow Coma Scale score of 15 and a systolic blood pressure of 70 mm Hg, which improved after crystalloid infusion. Abdominal examination revealed percussion tenderness consistent with peritonitis. Laboratory results revealed an elevated white blood cell count. Abdominal computed tomography revealed a 24 × 18-cm abnormality in segments VI and VII with evidence of metallic coils in a branch of the right hepatic artery (Figure 1and Figure 2). It was presumed that these coils were remnants from the management of the blunt hepatic injury sustained a month prior. In the presence of sepsis with hypotension and physical examination findings confirming peritonitis, an urgent exploratory midline laparotomy was performed following administration of antibiotics and a brief crystalloid resuscitation.