[Major liver injury. Role of preoperative transcutaneous endoluminal aortic clamping].
Severe contusion of the liver (type V in the Moore and Flint classification) still has a very poor prognosis. Exsanguination may lead to cardiac arrest when the abdomen is opened. Three patients with major liver injury were treated after percutaneous intra-aortic balloon occlusion and complete vascular exclusion of the liver. Two patients survived and one died due to complications resulting from lung trauma. The aorta was occluded with a balloon catheter inserted via the femoral route. The hepatic vascular exclusion was performed surgically after resuscitation had reestablished a satisfactory haemodynamic situation. Liver resection could then be performed under safe conditions. Aortic occlusion is a simple procedure with minimal disadvantages which could improve prognosis of major liver contusion by reducing the rate of intra-operative death.
Segol
P
P
Service de Chirurgie digestive et Transplantation, CHU de Caen.
Salame
E
E
Auvray
S
S
Marchand
P
P
Tartière
J
J
D001011:Aorta; D002406:Catheterization, Peripheral; D003288:Contusions / Q000601:surgery*; D006801:Humans; D008026:Ligation; D008099:Liver / Q000293:injuries*; D011300:Preoperative Care
Traumatisme hépatique majeur. Intérêt du clampage aortique endoluminal transcutané pré-opératoire.