Pulmonary embolism, an unrecognized risk of post-traumatic arterio-venous fistulae of the hepatic veins (1 case)]

A stab wound of the right lobe of the liver, initially treated by suture, led to the development of a large arterio-venous fistula with hemobilia. Re-operation on the 23rd day in order to carry out right hepatectomy, was rapidly followed by a massive and recurrent pulmonary embolism. A Trendelenburg operation associated with right hepatectomy did not prevent the patient's death. This risk of pulmonary embolism during post-traumatic hematoma of the liver is not fully recognised and the authors suggest, in cases of arterio-venous fistula of the hepatic veins, primary vascular exclusion of the supra-hepatic vena cava.