[Perihepatic packing combined with wrapping in the treatment of major bi-lobar hepatic trauma].
After the spleen the liver is the most exposed organ to injury in abdominal blunt trauma. The improvement in imaging techniques and in anesthesia and intensive care have contributed to a fallen in mortality rate and an enhanced possibility in non-operative management. In unstable patients the packing may be used to defer the definitive operation. The Authors report a case of liver injury of two lobes where the packing was followed by liver wrapping with an absorbable mesh. The patient, a female aged 67, resulted to have a bilobar liver injury of IV degree in the injury severity score. The delay of reoperation was 15 days. The procedure was complicated by a subphrenic abscess, successfully managed with non-operative procedures. Wrapping after liver packing may be considered a good option in unstable patient affected, by severe liver injuries after blunt abdominal traumas.
Cirocchi
R
R
Dipartimento di Chirurgia ed Emergenze Chirurgiche, Università degli Studi, Perugia.
Contine
A
A
Mazieri
M
M
Bisacci
R
R
Fabbri
C
C
Bisacci
C
C
Fabbri
B
B
D000368:Aged; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D008099:Liver / Q000293:injuries* / Q000601:surgery; D009104:Multiple Trauma / Q000601:surgery*; D009779:Occlusive Dressings; D012086:Reoperation; D012421:Rupture / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000601:surgery*