Retractor-related liver injury after surgery: MRI findings in a case

Liver retraction-related injury is a rare complication of gastrointestinal surgery, usually clinically silent and not life-threatening. We present an 86-year-old male patient admitted to our hospital for a laparoscopic cholecystectomy that ended in a 300-minute laparotomy after surgical complications. Twenty-four hours after the surgery an MRI was performed due to suspected biliary tract injury. MRI revealed bile leak and a new liver lesion not present in preoperative MRI, it was initially interpreted as edema. Clinical course and follow up MRI eventually suggested de diagnosis of retractor-related liver injury. In the case, a collaborative dialogue with the surgical team to correlate morphology and intraoperative placement of the retractor together with radiological findings are key factors to the diagnosis.