CT of focal hepatic injury due to surgical retractor.

OBJECTIVE This study reports the CT appearance of changes in the liver due to retractor injury during surgery for upper gastrointestinal malignancy. SUBJECTS AND METHODS Ten patients underwent CT examination of the abdomen before (n = 6) and after (n = 10) IV contrast enhancement 2-6 months after surgical resection of malignancy involving the gastric cardia. At each operation, a modified Weinberg's retractor was placed under the lateral segment of the left lobe of the liver to retract it and expose the esophagogastric junction. RESULTS A sharply marginated, focal, hypodense lesion with no mass effect was shown in the lateral segment of the left lobe of the liver on unenhanced scans in six patients. Irregular enhancement was present after contrast injection in all 10 patients. All patients had a normal preoperative CT of the liver. No patient revealed clinical or laboratory evidence of liver metastasis or abscess. CONCLUSION Focal hepatic injury due to intraoperative retraction has a typical location and CT appearance that can aid in recognition of the injury.