case_images: PMC4208444_01
case_images: Abdominal CT scan showing no hepatic parenchymal injury.
case_images: CRIHEP2013-524371.001.jpg
case_images: PMC4208444_01_CRIHEP2013-524371.001.jpg
case_images: fig1
case_images: A repeat CT of the abdomen and chest was obtained to identify concealed blood loss, but again negative (Figure 1).
case_images: Laboratory trends from the emergency room to hospital day 13: Aspartate transaminase (AST) and alanine transaminase (ALT) (a); total and direct bilirubin (b), gamma glutamyltranspeptidase (GGT) and alkaline phosphatase (Alk Phos) (c), and serum lactate (d).
case_images: CRIHEP2013-524371.002.jpg
case_images: PMC4208444_01_CRIHEP2013-524371.002.jpg
case_images: fig2
case_images: Hypoglycemia improved and stabilized with a glucose infusion rate of 6-8 mg/kg/min with gradual improvement in lactic acidosis (Figure 2(d)). The patient continued to receive supportive care over the course of the next week with stabilization of respiratory status, improvement in renal function, and improvement in his coagulopathy and liver failure (Figure 2).