INTRAHEPATIC HEMATOMA WITH SECONDARY SALMONELLA INFECTION VIA BILIARYFISTULA

Usually liver hematoma after blunt trauma is treated conservatively as long as clinically possible, in, order to avoid infection, via draina ge. We report a patient who developed a huge liver abscess after a min or blunt trauma caused by a piece of wood that hit his hepatic region during work with a circular saw. Neither conservative treatment nor pe rcutaneous drainage was successful and intraoperatively a biliary fist ula was identified as the route of infection. by salmonella. Cholecyst ectomy (here meaning removal of the salmonella reservoir) and conseque nt drainage of the gall flow via T-drain were the crucial therapeutic steps and the fistula finally closed after three months. Therapeutic p ossibilities in the management of blunt liver trauma, and biliary and septic complications are discussed.