How to Grade? - Grey Zone Cases

Over the past five years, we were confronted with a couple of clinical cases, in which the grading of complications turned out to be difficult. Such cases were prospectively collected at our center.



Example of "grey zone cases"




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Scenario 1:
A 63-year-old man underwent a right hemiliver resection for a hepatocellular carcinoma. The patient complained about right upper quadrant pain and developed a fever on postoperative day 4. A CT scan revealed an infected biloma in the right upper quadrant, which was drained percutaneously. After successful drainage of the biloma, the patient became acutely dyspnoeic due to a significant pneumothorax. A thorax drain was inserted to treat the pneumothorax.


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