A 32-year-old man undergoes a laparotomy for multiple organ injury resulting from trauma. He is discharged after 2 weeks in the hospital, only to be readmitted 3 days later because of abdominal pain and sepsis. The CAT scan shows an accumulation of fluid in the subhepatic space (Figure below). This space is likely to be directly related to an injury involving which structure?Subhepatic space; anterior view
Subhepatic (intrahepatic) space infection usually occurs after surgery or peritonitis in the supracolic compartment. It is an unlikely amplication of biliary pancreatitis. Infections in the subhepatic space may extend to the infra- colic compartment via the paracolic gutter (of Morrison). In addition to the stomach, the subhepatic space may be involved with infection secondary to injury or diseases of the gallbladder, the first part of the duodenum, the anterior portions of the pancreas, or the liver. The uncinate lobe of the pancreas is the part of the head located posteriorly to the superior mesentric artery vein.
Inferior pole of the right kidney
Stomach
Uncinate process of the pancreas
Aortic bifurcation
Stomach & Duodenum