Embolism of massive hepatic tissue in inferior vena cava and right atrium after closed liver injury

Embolism from liver tissue in a major vessel in coincidence with a severe injury to the liver is a rare phenomenon. We report a case of a 4-year-old boy who was involved in a traffic accident and died shortly after the accident. An autopsy revealed that an intrahepatic inferior vena caval injury was accompanied by a severe closed injury to the liver; the crushed liver fragment was driven through the lacerated wall into the inferior vena cava and almost completely occluded its lumen. The crushed liver flap further extended over into the right atrial cavity. Careful microscopic examination of the lungs showed no emboli of hepatic tissue.