Published online May 26, 2020. doi: 10.12998/wjcc.v8.i10.2016
Peer-review started: January 10, 2020
First decision: March 18, 2020
Revised: March 26, 2020
Accepted: April 15, 2020
Article in press: April 15, 2020
Published online: May 26, 2020
Processing time: 136 Days and 8.2 Hours
Liver infarction is a rare necrotic lesion due to the dual blood supply consisting of the hepatic artery and portal vein. The absence of specific clinical manifestations and imaging appearances usually leads to misdiagnosis and poor prognosis. Thus, the precise diagnosis of liver infarction always requires imaging studies, serum studies, and possible liver biopsy.
We report a case of 31-year-old man who developed a huge liver infarction. Persistent right upper abdominal pain and intermittent fever were the main symptoms in this patient. Computed tomography revealed a huge irregular lesion with a maximum diameter of 12.7 cm in the right lobe of the liver. Three-dimensional reconstruction was performed and no significant interruption of the main hepatic vessels was observed. The lesion was initially considered to be a malignant tumor with internal bleeding. Laparoscopic right hepatectomy was performed, and pathology indicated a rare liver infarction. The patient recovered well and was discharged on postoperative day 21. No fever or abnormal liver function were reported in the subsequent 6 mo.
In patients with a huge liver infarction, early surgical intervention may be beneficial.
Core tip: We report a case of liver infarction that was initially considered to be a tumor with bleeding based on computed tomography. Liver infarction is caused by the obstruction of hepatic vessels, and a huge liver infarction is very rare due to the dual hepatic blood supply. The clinical manifestations and imaging appearances of liver infarction are nonspecific. The precise diagnosis always requires multiple imaging methods, serum studies, and pathological examination. In addition to conservative treatment, early surgical intervention is beneficial in patients with a huge liver infarction. This case report provides a valuable reference for the diagnosis and treatment of this disease.