BACKGROUND: Following a motorcycle accident, a 30-year-old male with multiple traumas-including liver rupture, traumatic fractures, cerebral hemorrhage, hepatic hematoma and respiratory failure-was referred to a university medical center. After initial stabilization, the patient developed pneumonia, acute kidney failure requiring intermittent hemodialysis, superinfection of the hepatic hematoma and systemic bacterial infection with multiple drug-resistant bacteria. The patient developed acute liver failure 8 weeks after the initial trauma. INVESTIGATIONS: Laboratory investigations, Doppler ultrasound, CT, ultrasound, angiography, endoscopic retrograde cholangiography, liver biopsy, bacteriology and X-ray. DIAGNOSIS: Sclerosing cholangitis in a critically ill patient. MANAGEMENT: Orthotopic liver transplantation.
