title: [Perihepatic packing combined with wrapping in the treatment of major bi-lobar hepatic trauma].
abstract: 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.
authors.affiliation: Dipartimento di Chirurgia ed Emergenze Chirurgiche, Università degli Studi, Perugia.
authors.forename: R
authors.initials: R
authors.lastname: Cirocchi
authors.forename: A
authors.initials: A
authors.lastname: Contine
authors.forename: M
authors.initials: M
authors.lastname: Mazieri
authors.forename: R
authors.initials: R
authors.lastname: Bisacci
authors.forename: C
authors.initials: C
authors.lastname: Fabbri
authors.forename: C
authors.initials: C
authors.lastname: Bisacci
authors.forename: B
authors.initials: B
authors.lastname: Fabbri
mesh_terms: 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*